Paediatric Ophthalmology

Case 3


 

Patient Presentation: An 11-year-old boy was referred to a pediatric ophthalmology clinic from his optometrist for concern of bilateral optic nerve head swelling. The patient went to his optometrist for routine examination and a glasses update; he was asymptomatic with no headaches or visual changes. The patient denied past medical or ocular history. Best corrected distance visual acuity was 20/20 OD and 20/20-2 OS; IOP was 14 OD and 12 OS. There was no RAPD. Colour fundus photographs and OCT line scans of the optic nerves were taken and are shown below:
 

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Question 1: What main finding is seen in the OCT images above?

Question 2: What is the most likely diagnosis?

Question 3: What other imaging modalities can be used to confirm the diagnosis of optic disc drusen?

Question 4: What is the most common visual field deficit seen with ODD?

Learning Objectives:

  1. Understand the signs of optic disc drusen on OCT and multimodal imaging.

  2. Differentiate optic disc drusen from papilledema.