Monday, February 7, 2011

Picture Perfect

Oh, there were so many responses to the last few cases, this might ruin that.

A 75 year old African American gentleman with a positive family history of this disease comes to his usual annual eye appointment. He has no symptoms; no pain, redness, halos, or other eye problems. He's not aware of any vision loss, though exam shows:

His vision is as follows:Challenge: What is the most likely diagnosis?

First image shown under Fair Use. Second and third images are in the public domain.


sid said...

Retinitis pigmentosa..... such patients have tunnel vision....

Bas & Marloes, aka the internerds said...


Craig Chen said...

yes, was going for glaucoma...might do retinitis pigementosa in the future though
Picture Perfect

This is primary angle closure laucoma, the second leading cause of blindness (the first is cataracts). Although this presents with peripheral vision loss in the setting of increased intraocular pressure, many patients have no symptoms. The first image shows enlargement of the cup and an inferotemporal neuroretinal rim.

Sources: UpToDate; Wikipedia.