University of Rochester Flaum Eye Institute

Total Page:16

File Type:pdf, Size:1020Kb

University of Rochester Flaum Eye Institute University of Rochester Flaum Eye Institute State-of-the-art eye care… it’s available right here in Rochester. No one should live with vision that is less than what it can be. People who have trouble seeing often accept their condition, not knowing that treatment is available — from the simplest of medications and visual tools to state-of-the-art surgical procedures. Now you can easily refer them to the help they need — all at the Flaum Eye Institute at the University of Rochester. See the dierence we can make in your patients’ quality of life. Refer them today to 585-273-EYES. University of Rochester Flaum Eye Institute A world-class team of ophthalmologists, sub- specialists, and researchers, the faculty practice is committed to developing and applying advanced technologies for the preservation, enhancement, and restoration of vision. Working through a unique partnership of academic medicine, private industry, and the community, we are here to serve you and your patients. One phone number for all faculty practice appoint- ments and new centralized systems make the highest quality eye care more accessible than ever before. Working together, our physicians provide a full range of treatment options for the most common to the most complex vision problems. Glaucoma Cataract Macular Degeneration Diabetic Retinopathy Orbital Diseases Low Vision Dry Eye Syndrome Refractive Surgery Optic Neuropathies Corneal Disease Oculoplastics Motility Disorders Comprehensive Eye Care All-important routine eye exams and a wide range of procedures are oered through the Comprehensive Eye Care service. Consultative, diagnostic, and treatment services are all provided for patients with conditions or symptoms common to cataracts, dry eye, glaucoma, and corneal surface disorders. Medical, surgical, and laser treatment modalities are available through the Comprehensive Eye Care service. Cornea and External Disease Diseases of the anterior section of the eye and cornea and infectious eye diseases are the focus of the cornea and external disease service along with general ophthalmic care and screen- ing for eye complications of systemic diseases and contact lens wear. Adult and pediatric evaluation and consultation are facilitated by advanced diagnostic options and treatment modalities. They include corneal transplantation, anterior segment reconstruction, intraocular lens implantation, cataract extraction, and excimer laser phototherapeutic procedures. Glaucoma The Flaum Eye Institute is a state-of-the-art center for the management of glaucoma. Patients may be referred for retinal topography and analysis, utilizing the Heidelberg Retinal Tomograph along with computerized visual eld testing, optic nerve imaging, and other specialized imaging modalities. Even the most complex adult and pediatric glaucoma cases and surgical complications are managed by the Flaum Eye Institute’s Glaucoma Service. Neuro-Ophthalmology and Oculoplastics Patients with symptoms of visual loss unexplained by ndings inside the eye, double vision, headache, and protrusion of the eye are appropriately referred to neuro-ophthalmology. Associated diseases may include cranial nerve palsies, disorders of the optic nerve, visual eld loss, nystagmus, optic neuritis and other optic neuropathies, thyroid-associated eye disease, migraine, and idiopathic intracranial hypertension. Surgical expertise includes orbital tumors, socket recon- struction, eyelid repair, and orbital decompression, as well as correction of paralytic strabismus. Refractive Surgery Leaders in the eld of refractive surgery have put Rochester at the forefront of development, safety, and eectiveness in laser vision correction technology. Until recently we could only measure astigmatism, nearsightedness, and farsightedness. Today, through wavefront sensing technology developed by the Rochester team, many aberrations can be detected and treated with LASIK. Through customized ablation, patients’ vision may be restored or improved—possibly even better than 20/20. Free informational seminars are oered to patients who may be candidates for LASIK surgery. The Flaum Eye Institute Refractive Surgery Center oers 26-point evaluation process including Orbscan and Zywave—the most complete refractive surgery evaluation in the region. Retina and Vitreous Age-related macular degeneration (the leading cause of blindness in older Americans), diabetic retinopathy, detached retinas, and other vascular abnormalities of the retina and choroid are treated and managed through the Retina and Vitreous Service. From indocyanine green angiography (IGA) to laser treatment, photodynamic therapy (PDT), and surgery, this service oers comprehensive care for adults and children. When do you refer a patient to the Flaum Eye Institute? The University of Rochester Flaum Eye Institute is your regional resource for tertiary and quaternary eye care services. Contact us for: • A second opinion by an experienced sub-specialist • Consultative services on eye complications of systemic disease and contact lens wear • Highly specialized testing and diagnostic services • Access to the latest state-of-the-art treatment modalities • Advanced surgical interventions • Management of the most complex eye conditions and diseases Call us at 585-273-EYES. University of Rochester Flaum Eye Institute Eye Care Services at a Glance Comprehensive Eye Care Cornea and External Disease Glaucoma Neuro-Ophthalmology/Orbit Oculoplastics Refractive Surgery Retina and Vitreous University of Rochester Flaum Eye Institute Box 659 601 Elmwood Avenue Rochester, NY 14642 585-2 73-EYES www.mc.rochester.edu/eye-institute/.
Recommended publications
  • Plastics-Roadmap
    Oculoplastics Roadmap Idea for New Intern Curriculum Interns should spend at least 1 Friday afternoon in VA Oculoplastics OR; Friday PM is already protected time. Interns should practice 100 simple interrupted stitches and surgeon’s knots in the Wet Lab before PGY2. Lectures (2 hour interactive sessions) Basic Principles of Plastic Surgery and Oculoplastics (Year A = Year B) Trauma Management (Year A: Orbit trauma. Year B: Eyelid trauma.) Eyelid malpositions and dystopias (Year A: Entropion, Ectropion, Ptosis. Year B: spasm, dystonias) Eyelid Lesions: benign and malignant (Year A = Year B) Lacrimal Disorders (Year A: Pediatric. Year B: Adult.) Orbital Disorders (Year A: Acquired. Year B: Congenital.) Core Topics (to be discussed on rotation) Thyroid eye disease management Ptosis evaluation and recommendations Ectropion/entropion management Orbital fracture management Orbit imaging modalities Home Study Topics Orbit anatomy Congenital malformations Surgical steps and instruments Clinical Skills (to be learned on rotation) External photography Lid and orbit measurements Chalazion and lid lesion excisions Punctal plug placement Local anesthetic injection of lids (important for call!) Schirmer Testing, Jones Testing NLD probing/irrigation Canthotomy/cantholysis (in the OR) Directed Reading (residents will read BCSC and article abstracts at home) BCSC Henderson et al. Photographic standards for facial plastic surgery. Arch Facial Plast Surg. 2005. Strazar et al. Minimizing the pain of local anesthesia injection. Plastic and Reconstructive Surgery. 2013. Simon et al. External levator advancement vs Müller’s muscle–conjunctival resection for correction of upper eyelid involutional ptosis. American Journal of Ophthalmology. 2005. Harris and Perez. Anchored flaps in post-Mohs reconstruction of the lower eyelid, cheek, and lateral canthus.
    [Show full text]
  • Online Ophthalmology Curriculum
    Online Ophthalmology Curriculum Video Lectures Zoom Discussion Additional videos Interactive Content Assignment Watch these ahead of the assigned Discussed together on Watch these ahead of or on the assigned Do these ahead of or on the Due as shown (details at day the assigned day day assigned day link above) Basic Eye Exam (5m) Interactive Figures on Eye Exam and Eye exam including slit lamp (13m) Anatomy Optics (24m) Day 1: Eye Exam and Eye Anatomy Eyes Have It Anatomy Quiz Practice physical exam on Orientation Anatomy (25m) (35m) Eyes Have It Eye Exam Quiz a friend Video tutorials on eye exam Iowa Eye Exam Module (from Dr. Glaucomflecken's Guide to Consulting Physical Exam Skills) Ophthalmology (35 m) IU Cases: A B C D Online MedEd: Adult Ophtho (13m) Eyes for Ears Podcast AAO Case Sudden Vision Loss Day 2: Acute Vision Loss (30m) Acute Vision Loss and Eye Guru: Dry Eye Ophthalmoscopy and Red Eye Eye Guru: Abrasions and Ulcers virtual module IU Cases: A B C D E Red Eye (30m) Corneal Transplant (2m) Eyes for Ears Podcast AAO Case Red Eye #1 AAO Case Red Eye #2 EyeGuru: Cataract EyeGuru: Glaucoma Cataract Surgery (11m) EyeGuru: AMD Glaucoma Surgery (6m) IU Cases: A B Day 3: Intravitreal Injection (4m) Eyes for Ears Podcast Independent learning Chronic Vision Loss (34m) Chronic Vision Loss AAO Case Chronic Vision Loss reflection (due Day 3 at 8 and and Systemic Disease pm) Systemic Disease (32m) EyeGuru: Diabetic Retinopathy IU Cases: A B Eyes Have It Systemic Disease Quiz AAO Case Systemic Disease #1 AAO Case Systemic Disease #2 Mid-clerkship
    [Show full text]
  • Oculoplastics/Orbit 2017-2019
    Academy MOC Essentials® Practicing Ophthalmologists Curriculum 2017–2019 Oculoplastics and Orbit *** Oculoplastics/Orbit 2 © AAO 2017-2019 Practicing Ophthalmologists Curriculum Disclaimer and Limitation of Liability As a service to its members and American Board of Ophthalmology (ABO) diplomates, the American Academy of Ophthalmology has developed the Practicing Ophthalmologists Curriculum (POC) as a tool for members to prepare for the Maintenance of Certification (MOC) -related examinations. The Academy provides this material for educational purposes only. The POC should not be deemed inclusive of all proper methods of care or exclusive of other methods of care reasonably directed at obtaining the best results. The physician must make the ultimate judgment about the propriety of the care of a particular patient in light of all the circumstances presented by that patient. The Academy specifically disclaims any and all liability for injury or other damages of any kind, from negligence or otherwise, for any and all claims that may arise out of the use of any information contained herein. References to certain drugs, instruments, and other products in the POC are made for illustrative purposes only and are not intended to constitute an endorsement of such. Such material may include information on applications that are not considered community standard, that reflect indications not included in approved FDA labeling, or that are approved for use only in restricted research settings. The FDA has stated that it is the responsibility of the physician to determine the FDA status of each drug or device he or she wishes to use, and to use them with appropriate patient consent in compliance with applicable law.
    [Show full text]
  • ED Ophthalmology Guidelines
    Ophthalmology Guidelines for Family Physicians & the Emergency Department Revised March 2018 Department of Ophthalmology Introduction 1 Referral Guidelines 2 Referral Categories 3 Driving to Ophthalmology Appointments 3 Patients Known to Ophthalmology 4 Contacting Ophthalmology 5 Contacting Winnipeg Ophthalmologists 5 On Call Ophthalmologist in Brandon 7 Contact Details for Retina Specialists 7 Management Guidelines 8 Chemical Injuries 8 Visual Phenomena 10 The Chronic Red Eye 11 The Acute Red Eye 12 Ocular & Peri-Ocular Pain 16 Blurred Vision & Loss of Vision 17 Orbital & Peri-Orbital Swelling 19 Eyelid and Lacrimal Pathology 20 Diplopia 21 Pupils 22 Trauma 23 Specific Paediatric Ophthalmic Presentations 29 Appendices 30 Triage Guidelines 30 Minimal Standards of Documentation 30 Visual Requirements for Driving 31 Eye Patches and Eye Shields 32 Ophthalmology Guidelines, revised March 2018 Department of Ophthalmology Use of Eye Drops and Eye Ointments 33 Everting the Upper Eyelid 34 Analgesia for Painful Eyes 35 Slit Lamp Basics 36 Using a Tonopen 39 Using an iCare Tonometer 41 Image Gallery 42 Ophthalmology Guidelines, revised March 2018 Department of Ophthalmology Introduction This document has been compiled by the Department of Ophthalmology to assist emergency physicians and family doctors in the management of patients presenting with ophthalmic complaints. It is not intended to be a comprehensive text on ophthalmic emergencies, but rather provide reasonable guidelines for acute management and referral. The first sections give advice on how and when to refer patients, how to deal with patients who have perviously been seen by an ophthalmologist, and contact details for the ophthalmologists who take call. The latter half details common presentations, recommendations for management in the Emergency Department and how urgently they should be referred.
    [Show full text]
  • ICO Residency Curriculum 2Nd Edition and Updated Community Eye Health Section
    ICO Residency Curriculum 2nd Edition and Updated Community Eye Health Section The International Council of Ophthalmology (ICO) Residency Curriculum offers an international consensus on what residents in ophthalmology should be taught. While the ICO curriculum provides a standardized content outline for ophthalmic training, it has been designed to be revised and modified, with the precise local detail for implementation left to the region’s educators. Download the Curriculum from the ICO website: icoph.org/curricula.html. www.icoph.org Copyright © International Council of Ophthalmology 2016. Adapt and translate this document for your noncommercial needs, but please include ICO credit. All rights reserved. First edition 201 6 . First edition 2006, second edition 2012, Community Eye Health Section updated 2016. International Council of Ophthalmology Residency Curriculum Introduction “Teaching the Teachers” The International Council of Ophthalmology (ICO) is committed to leading efforts to improve ophthalmic education to meet the growing need for eye care worldwide. To enhance educational programs and ensure best practices are available, the ICO focuses on "Teaching the Teachers," and offers curricula, conferences, courses, and resources to those involved in ophthalmic education. By providing ophthalmic educators with the tools to become better teachers, we will have better-trained ophthalmologists and professionals throughout the world, with the ultimate result being better patient care. Launched in 2012, the ICO’s Center for Ophthalmic Educators, educators.icoph.org, offers a broad array of educational tools, resources, and guidelines for teachers of residents, medical students, subspecialty fellows, practicing ophthalmologists, and allied eye care personnel. The Center enables resources to be sorted by intended audience and guides ophthalmology teachers in the construction of web-based courses, development and use of assessment tools, and applying evidence-based strategies for enhancing adult learning.
    [Show full text]
  • 2018-2019 Curso De Liderazgo
    Pan-American Association of Ophthalmology 2018-2019 Curso de Liderazgo Participant List Dr. Alexandre Antonio Marques Rosa Conselho Brasileiro de Oftalmologia ................................................................................................................................... 1 Dra. Andreia de Faria Martins Rosa* Sociedade Portuguesa de Oftalmologia ................................................................................................................................ 3 Dra. Carla Sabrina Vitelli* Consejo Argentino de Oftalmología ..................................................................................................................................... 4 Dr. Carlos Andrés Wong Morales APTO (Asociación Panamericana de Trauma Ocular) ......................................................................................................... 5 Dra. Claudia Acosta Sociedad Colombiana de Oftalmología ................................................................................................................................ 6 Dr. Francisco Arnalich Montiel Sociedad Española de Oftalmología ..................................................................................................................................... 7 Dr. Gabriel Salomón Lazcano Gomez PAGS (Sociedad Panamericana de Glaucoma) .................................................................................................................... 8 Dr. Jaime Soria Viteri* Sociedad Ecuatoriana de Oftalmología ...............................................................................................................................
    [Show full text]
  • Punctal Stenosis: Definition, Diagnosis, and Treatment
    Clinical Ophthalmology Dovepress open access to scientific and medical research Open Access Full Text Article REVIEW Punctal stenosis: definition, diagnosis, and treatment Uri Soiberman1 Abstract: Acquired punctal stenosis is a condition in which the external opening of the lacrimal Hirohiko Kakizaki2 canaliculus is narrowed or occluded. This condition is a rare cause of symptomatic epiphora, Dinesh Selva3 but its incidence may be higher in patients with chronic blepharitis, in those treated with various Igal Leibovitch1 topical medications, including antihypertensive agents, and especially in patients treated with taxanes for cancer. The purpose of this review is to cover the medical literature, focusing in 1Division of Oculoplastic and Orbital Surgery, Department of particular on definition, incidence, risk factors, etiology and treatment options. Ophthalmology, Tel-Aviv Medical Keywords: acquired punctal stenosis, definition, epiphora, etiology, treatment Center, Tel-Aviv University, Tel-Aviv, Israel; 2Department of Ophthalmology, Aichi Medical University, Nagakute, Introduction Japan; 3South Australian Institute of Ophthalmology and Discipline of Epiphora is a common complaint encountered by ophthalmologists, with a broad dif- Ophthalmology and Visual Sciences, ferential diagnosis. One of the least discussed etiologies of epiphora is stenosis of the University of Adelaide, South Australia, Australia external lacrimal punctum. When it occurs, the most common presenting symptom is tearing, but patients may have vague complaints of ocular discomfort.1 Stenosis must be distinguished from complete occlusion of the puncti, which differs in its treatment and prognosis. This review relates only to punctal stenosis. Anatomically, acquired punctal stenosis is a condition in which the external opening of the lacrimal canaliculus, located in the nasal part of the palpebral margin, is narrowed or occluded.
    [Show full text]
  • Visionamerica of Birmingham
    VisionAmerica of Birmingham EYE HEALTH PARTNERS OF ALABAMA AND TENNESSEE TRENTON CLEGHERN, OD, FAAO Our Mission Provide the highest quality of medical and surgical eye care available while advocating the cooperative efforts of optometry and ophthalmology through clinical care, education and research. Multi-specialty medical and surgical eye Care No Primary Care Services Medical eye care Cataract and refractive surgery Cornea surgery Retina Oculoplastics Medical and surgical management of glaucoma Neuro-ophthalmology Pediatrics and strabismus Genetic eye disease and electrophysiological testing VisionAmerica of Birmingham Paul Batson, OD Regional Executive Director Jill Helton, OD Assistant Center Director Trenton Cleghern, OD Consultative Optometrist Rod Nowakowski, OD, PhD Genetic Eye Disease and Electrodiagnostics Donald McCurdy, MD Cataract Surgeon Jeff Fuller, MD Retinal Specialist Irene Ludwig, MD Pediatric and Strabismus Surgeon Matthew Albright, MD Cataract and Cornea Surgeon Dale Brown, MD Retina Specialist Kristin Madonia, MD Neuro-ophthalmologist and Oculoplastics Michael Eddins, MD Cataract Surgeon Anterior Segment/General Medical Eye Care Topical/Clear Cornea Cataract Surgery Same Day Cataract Surgery Toric and Presbyopic IOL’s YAG Capsulotomy Laser Trabeculoplasty Laser Peripheral Iridotomy Pterygium Surgery Uveitis Glaucoma Management Cornea Corneal Ulcers Superficial Keratectomy Intacs for Keratoconus Corneal Transplants Descemet Stripping Endothelial Keratoplasty (DSAEK) Oculoplastics Blepharoplasty Ptosis repair Forehead
    [Show full text]
  • Evisceration in the Modern Age
    Review Article Evisceration in the Modern Age Laura T. Phan1,2, Thomas N. Hwang3, Timothy J. McCulley1,2 ABSTRACT Access this article online Website: Evisceration is an ophthalmic surgery that removes the internal contents of the eye www.meajo.org followed usually by placement of an orbital implant to replace the lost ocular volume. DOI: Unlike enucleation, which involves removal of the entire eye, evisceration potentially causes 10.4103/0974-9233.92113 exposure of uveal antigens; therefore, historically there has been a concern about sympathetic Quick Response Code: ophthalmic (SO) associated with evisceration. However, critical review of the literature shows that SO occurs very rarely, if ever, as a consequence of evisceration. Its clinical applications overlap with those of enucleation in cases of penetrating ocular trauma and blind painful eyes, but it is absolutely contraindicated in the setting of suspected intraocular malignancy and may be preferred for treatment of end-stage endophthalmitis. From a technical standpoint, traditional evisceration has a limitation in the orbital implant size. Innovations with scleral modification have overcome this limitation, and accordingly, due to its simplicity, efficiency, and good cosmetic results, evisceration has once again been gaining popularity. Key words: Endophthalmitis, Enucleation, Evisceration, Intraocular Tumors INTRODUCTION While the risk of sympathetic ophthalmia continues to be a contentious issue, evisceration has gained popularity in the visceration (removal of intraocular contents) and enucleation past few decades. This is based largely on the perception E(removal of the entire eye) are competing techniques, with that evisceration provides superior functional and cosmetic fluctuating favor since their inception. Enucleation may be the results compared to enucleation.
    [Show full text]
  • Online Ophthalmology Curriculum
    Online Ophthalmology Curriculum Video Lectures Zoom Discussion Additional videos Interactive Content Assignment Watch these ahead of the assigned Discussed together on Watch these ahead of or on the assigned Do these ahead of or on the Due as shown (details at day the assigned day day assigned day link above) Basic Eye Exam (5m) Interactive Figures on Eye Exam and Eye exam including slit lamp (13m) Anatomy Optics (24m) Day 1: Eye Exam and Eye Anatomy Eyes Have It Anatomy Quiz Practice physical exam on Orientation Anatomy (25m) (35m) Eyes Have It Eye Exam Quiz a friend Video tutorials on eye exam Iowa Eye Exam Module (from Dr. Glaucomflecken's Guide to Consulting Physical Exam Skills) Ophthalmology (35 m) IU Cases: A B C D Online MedEd: Adult Ophtho (13m) Eyes for Ears Podcast AAO Case Sudden Vision Loss Day 2: Acute Vision Loss (30m) Acute Vision Loss and Eye Guru: Dry Eye Ophthalmoscopy and Red Eye Eye Guru: Abrasions and Ulcers virtual module IU Cases: A B C D E Red Eye (30m) Corneal Transplant (2m) Eyes for Ears Podcast AAO Case Red Eye #1 AAO Case Red Eye #2 EyeGuru: Cataract EyeGuru: Glaucoma Cataract Surgery (11m) EyeGuru: AMD Glaucoma Surgery (6m) IU Cases: A B Day 3: Intravitreal Injection (4m) Eyes for Ears Podcast Independent learning Chronic Vision Loss (34m) Chronic Vision Loss AAO Case Chronic Vision Loss reflection (due Day 3 at 8 and and Systemic Disease pm) Systemic Disease (32m) EyeGuru: Diabetic Retinopathy IU Cases: A B Eyes Have It Systemic Disease Quiz AAO Case Systemic Disease #1 AAO Case Systemic Disease #2 Mid-clerkship
    [Show full text]
  • Oculoplastics Product Catalog TABLE of CONTENTS
    Oculoplastics Product Catalog www.fciworldwide.com TABLE OF CONTENTS FCI SAS is a world leader in the development of a wide range of ophthalmic surgical devices. EPIPHORA Since the company’s inception in 1984, the innovative PUNCTAL STENOSIS / DACRYOCYSTOPLASTY / INTUBATION SETS 5 developments of FCI have helped physicians solve problems relating to retinal detachment, epiphora, dry eye, eyelids, and orbital surgery thanks to a wide range of innovative ophthalmic devices such as lacrimal balloon DRY EYE catheter, intubation sets without nasal retrieval, punctal plugs, eyelids and orbital implants. PUNCTAL PLUGS 23 FCI performs extensive research and development to provide physicians with outstanding products that enhance the efficiency and effectiveness of surgical procedures. EYELIDS This line of product is FCI latest commitment to provide PTOSIS / EYELID WEIGHTS / EYELID PATCHES 27 you high performance products in oculoplastic surgery. ORBIT ORBITAL IMPLANTS / SELF-INFLATING TISSUE EXPANDER / ACCESSORIES 37 OCULOPLASTICS INSTRUMENTS THIS PUBLICATION IS NOT INTENDED FOR DISTRIBUTION IN THE USA. 2 OCULOPLASTICS CATALOG 2014 WWW.FCIWORLDWIDE.COM 3 EPIPHORA TABLE OF CONTENTS EPIPHORA PUNCTAL STENOSIS 6 PVP perforated plugs DACRYOCYSTOPLASTY 7 Ophtacath® INTUBATION SETS 8 Monocanalicular intubation Mini-Monoka® Monocanalicular nasolacrimal intubations 9 Masterka® Self-threading Monoka® Monoka® of Fayet Monoka® Bicanalicular intubation 12 Autostable Intubation Set II Bicanalicular nasolacrimal intubations 13 FCI Nunchaku® Ritleng® lacrimal intubation Crawford probe Infant BIKA® Infant BIKA® II BIKA® FCI 2 probe BIKA® for DCR BIKA® 1.18 LACORHINOSTOMY 18 PVP Metaireau tubes INSTRUMENTS 19 Single use Reusable 4 EPIPHORA OCULOPLASTICS CATALOG 2014 WWW.FCIWORLDWIDE.COM EPIPHORA 5 EPIPHORA POLYVINYLPYRROLIDONE (PVP) PVP is an exclusive surface treatment applied to FCI lacrimal products to improve the hydrophilic properties of silicone.
    [Show full text]
  • Masqueraders of Glaucoma
    DIFFERENTIAL DIAGNOSIS s Masqueraders of Glaucoma BY MARK S. DIKOPF, MD; PETE SETABUTR, MD; THASARAT S. VAJARANANT, MD; AND SHANDIZ TEHRANI, MD, PHD BLEPHAROSPASM AND GLAUCOMATOUS VISUAL FIELD DEFECTS By Mark S. Dikopf, MD; Pete Setabutr, MD; and Thasarat S. Vajaranant, MD 72-year-old man with glau- erosions OU, mild nuclear sclerosis depression OS (Figure 2A). Continued coma was referred for evalu- OU, open angles on gonioscopy, and use of the prostaglandin analogue was A ation. His medical history inferior thinning of the optic disc OU recommended. included systemic hypertension (not (Figure 1). IOP was 16 mm Hg OD and On examination 3 months later, the on beta-blocker treatment), obstruc- 14 mm Hg OS on a nightly prosta- patient had IOPs of 15 mm Hg OU tive sleep apnea, hypercholesterolemia, glandin analogue drop. Inferior nerve with a stable arcuate defect OD and and diet-controlled diabetes mellitus. thinning was confirmed by OCT, and improved, scattered superior defects The patient’s BCVA was 20/20 OD 24-2 automated perimetry revealed a OS (Figure 2B). and 20/25 OS. Examination revealed fixation-threatening superior arcuate 1+ corneal punctate epithelial depression OD and a superior arcuate THE FOLLOWING YEAR Examination every 3 months over A B the following year showed mild punc- tate epithelial erosions and IOPs in the mid to low teens. Automated perimetry at each examination was also stable until redevelopment of a dense superior arcuate depression OS was noted (Figure 2C). Dilated fundus examination did not show retinal or new optic nerve head pathology cor- responding to the observed visual field (VF) defect.
    [Show full text]