Case 4

Patient Presentation: A 73-year-old female was referred from her optometrist after a dilated fundus examination demonstrated optic disc cupping bilaterally (OD > OS). Her visual acuity was 20/20 OD and 20/30 OS. IOP was 28 OD and 16 OS. Her angles were open bilaterally on gonioscopy. ONH/RNFL OCT and GCC OCT analyses were completed and shown below:

Glaucoma 4-1.png
Glaucoma 4-2.png

Question: What abnormalities seen on ONH/RNFL OCT in the right eye?

Question: Based on the patient’s OCT images, what visual field defect would you expect to see?

Question: What stage glaucoma does the patient have in the right eye?

Learning Objectives:
1. Interpreting RNFL and GCC OCT images in patients with severe glaucoma.
2. Staging glaucoma severity using HAP Criteria and central involvement.
3. Correlating OCT deficits with visual field changes.