Pressure Watcher

A 32-year-old African-American female presented to the office in January with complaints of fluctuating vision and blurriness in both eyes that tended to wax and wane. The symptoms started approximately two weeks earlier, and had a slightly progressive nature to the intensity and duration of the visual disturbances, prompting her urgent visit.

Prepping Your Diagnostic Toolbox

Today’s diagnostic technology is growing rapidly; not long ago, time-domain optical coherence tomography (TD-OCT) revolutionized the way we looked at certain ocular conditions such as glaucoma. Now, affordable high-resolution spectral-domain OCT performs everything from retinal nerve fiber to ganglion cell analysis, and even non-contact pachymetry and anterior segment angle evaluation, depending on the instrument. Here’s a look at traditional and innovative glaucoma diagnostics and how to incorporate them into daily clinical practice.

Missed Connections

An 88-year-old Caucasian female presented to the clinic with acute onset of pain and swelling around her left eye. She stated that about a week prior she had an upper respiratory infection, and after blowing her nose, she noted her left eye had become red and swollen. She also had a headache localized behind the left eye that persisted after the illness passed. She mentioned the onset of a “whooshing” sound in her left ear and double vision that gradually worsened in intensity over the past week. Her extensive medical history included hypertension, high cholesterol, congestive heart failure, chronic obstructive pulmonary disease, deep vein thrombosis, hypothyroidism, anxiety/depression and a history of lung cancer about 30 years ago.

MIGS: Getting Better All the Time

A 55-year-old woman under management for primary open angle glaucoma for the past 15 years presented for a checkup. Her peak intraocular pressures were 31mm Hg OD and 26mm Hg OS. She had moderate glaucomatous damage to each optic disc.