History / Objective Data
(This DGR case requires a VBScript-compatible browser to work optimally. You should either be using Microsoft Internet Explorer, or Netscape equipped with the NCompass ScriptActive plug-in. The answer can be viewed via straight HTML, as well... see the link at the end of the case history.)
This case was donated by Blair Lonsberry, B.Sc., M.Sc., OD of the Southern College of Optometry. Thanks so much Blair! A 61 year old African-American female presents with complaints of blur at distance and problems with glare. She had been previously diagnosed with myopic degeneration and cataracts. She also said she had been treated for hypertension for the past two years. Her family ocular history was unremarkable, but she did have an aunt with diabetes.
Best corrected vision was OD: 6/400 OS: 20/200 with significant myopia. Her refraction was OD: -9.25/-1.50 x 120, O: -6.50 sphere.
Pupils were normal. Her corneals showed scarring (stromal) with thinning (30-50%) centrally. Note the biomicroscopic image seen here. Endothelial Guttata and pigment present in both eyes, Fleisher’s ring noted in the left eye. Her lenses showed 3+ nuclear sclerosis with cortical changes.
IOP’s: 16 mm Hg OU.
Her dilated fundus evaluation showed C/D’s of 0.2 H/V OU. The right eye showed myopic degeneration with associated peripapillary atrophy, staphyloma and extensive macular scarring. The left eye showed myopic degeneration with associated peripapillary atrophy, staphyloma and minimal macular scarring.
PAM revealed potential acuities of 20/300 in the right eye and 20/60 in the left. Topography was performed and is here for your review. What is this condition and how should it be managed?
(Click HERE for answer if your browser doesn't support VBScript or RealAudio.)
Don't hesitate to contact me via E-Mail to waltmayo@sccoast.net. Please take the time to join us in discussing this and other cases on our Internet mailing list. You can subscribe by clicking HERE. With over 1100 doctors from 35+ countries participating, you're sure to have fun and learn something at the same time.
Please take the time to participate. The more that join in, the better the experience will be for all.
Thanks!
Walt Mayo, OD
Technology Director
Southern Council of Optometry
PO Drawer L / 400 Marina Drive
Georgetown, South Carolina 29442
WK: 803/546-8421
HM: 803/650-0140
FAX: 803/546-1173
Email: waltmayo@sccoast.net