Sponsored by:
Case 2: Comparison of GCC with Fundus Careful observation reveals a notch inferiorly OD, the eye with the larger disc. Both the larger disc and the inferior notch OD are likely congenital. The inferior notch OD appears to correspond to the inferior thinning of the GCC. The left disc and left GCC appear normal.
Case 2: Horizontal Section through Optic Nerve Head OU Note the larger cup OD above
Case 2: Color Fundus Image OU The fundus photos of this 51-year-old white female are depicted above. Note that the right disc appears larger than the left disc and both were obtained at the same magnification. The cup is also larger in the right eye. The history reveals a long standing slight reduction in vision
Case 2: Optovue iWellness Exam OU The Optovue iWellness Exam in Case 2 is shown above. The normal "green donut" is present in the left eye but much of the inferior green donut is missing in the right eye. The mean thickness of a normal green donut is 95 microns both inferiorly and superiorly and
Case 1: Comparing Objective Structure (GCC) & Objective Function (VEP) Objective structure (GCC) and objective function (VEPs) are both abnormal in the R.E. and confirm an optic neuropathy but do not identify a specific etiology. The VEP also appears delayed in the L.E. but the GCC appears intact. Do functional changes occur prior to structural
When a RNFL loss is not due to Glaucoma Once glaucoma has been ruled out, this mnemonic is helpful to remember other possible etiologies of RNFL loss in non-glaucomatous optic nerve disorders. See details in:
With the patient's distance prescription in place (with an additional +1.00 D to compensate for the 1 meter working distance), the central 5 degrees of the visual field is focused onto the central 5 degrees of the fundus which corresponds to the macula. Action potentials are then generated by the ganglion cells which are transmitted
Visual Evoked Potentials (VEPs) With VEPS, the patient is treated as a "black box" and the patient looks at checks (usually black and white) that pattern reverse-white checks to black and black checks to white at a specific reversal rate. The pattern reversal stimulus creates a change across the central retina and this change is
Case 1: Diopsys VEPs Visually evoked potentials (VEPs) were obtained with the new Diopsys system, the NOVA (Neuro Optic Vision Assessment). The specific program used was the DN (Diseases of the Optic Nerve) and each testing condition takes only 15 sec or so. Above are VEPS to low and high contrast levels through both the
Case 1: Progressive Field Loss OD Over the past year or so, the field loss has progressed in the right eye. Goldmann IOPs have remained in the mid teens and glaucomatous cupping is still not observable. However, glaucoma without glaucomatous cupping has been documented1 in select cases.
