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A 57-year-old woman with periocular pain
Digital Journal of Ophthalmology 2021
Volume 27, Number 3
September 3, 2021
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Bryan Strelow, MD, MA | Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina Michelle Nguyen, BS | School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina Meredith R. Klifto, MD | Department of Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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| Examination | | On examination, the patient was found to have corrected visual acuity of 20/25 in each eye, with mildly elevated and asymmetric IOPs of 20 mm Hg in the right eye and 27 mm Hg in the left eye. Pachymetry revealed slightly above-normal central corneal thickness of 616 μm on the right and 628 μm on the left. Her refraction was slightly hyperopic in both eyes (spherical equivalent +1.75 in the right eye and +2.25 in the left eye). Extraocular motility was full, and pupils were equal, round, and reactive, without relative afferent pupillary defect. Confrontation visual fields were intact. Anterior segment examination was unremarkable, except for nasal peripheral iridotomies, which were patent in both eyes, and trace nuclear sclerotic lenticular changes. Undilated posterior segment examination revealed symmetric cup-to-disc ratios of 0.6 in each eye, with healthy-appearing neuroretinal optic nerve head rims. Gonioscopic examination revealed narrow angles in both eyes, with no structures visible nasally, anterior trabecular meshwork visible temporally, and some posterior trabecular meshwork visible superiorly and inferiorly. Some areas of peripheral anterior synechiae were noted in both eyes during the examination. | |
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