Case 3

Patient Presentation: An 89-year-old woman presents for a routine evaluation of her eyes to screen for glaucoma. Her IOP is 15mmHg in both eyes on no glaucoma medication and she has an absence of any visual symptoms. She has no family history of glaucoma. Her past ocular history is unremarkable other than bilateral cataract extraction.

She receives an OCT ONH and RNFL of both her eyes. The results are shown below and compared with an OCT ONH and RNFL from 6 months prior.


Describe any pertinent findings from this first image.

The clinician then pulls up an OCT ONH and RNFL from 6 months prior, which showed the following:


Question: When comparing this OCT ONH/RNFL from 6 months ago to the OCT ONH/RNFL obtained today, what do you see is the same, and what do you see is different?

Question: What could explain this discrepancy?

Question: What group of people is the normative data for Zeiss Cirrus machines collected from?

Learning Objectives:

1. Recognize the importance of checking date of birth on the OCT ONH/RNFL for all patients
2. Understand the database used to collect “normative” data as a reference in OCT analyses
3. Understand the importance of how age can affect findings on OCT ONH/RNFL