These discs belong to 2 different patients. Is it glaucoma? Now suppose both discs belong to one patient. Is it glaucoma?
First picture if isolated is not likely to be glaucoma as the NRR is healthy.. it can be physiological if symmetrical cupping in both the eyes.. but even physiological cupping should be advised to have atleast yearly screening for glucoma. second disc definitely glaucomatous.. superior notching, ISNT not followed.. back up these with field and Oct to show progression to qualify for glaucoma
Asymmetrical deep large cups left NRR atrophy bayonetting disc suggest glaucoma. If isolated patient right eye can be labeled glaucoma suspect due to large deep cup with bayonetting, IOP should be checked and Perimetry should be done
Just by seeing cupping we cannot say that it is glaucoma.Field charting should be done and IOP should be noted.Some discs have physiological cupping
Both pics ve large cups nd need further evaluation but second one looks more suspicious nd to confirm get vf iop repeated evaluation . Ist pic has healthy NRR
If belongs to same pt definitely it's a glaucoma as 0.2 difference s der.i wud lyk to go fr cct vf n baseline iop n RNFL changes
Even if it is of the same patient, the vertical C:D ratio is not very different than the other eye as the disc in the other eye is larger. However, there appears to be a focal loss of NRR superiorly which needs evaluation for corresponding areas of NFL dropouts in red free light, HFA for a corresponding visual field defect
second disc-definitely glaucomatous.if both pics belong to the same pt,then definitely glaucomatous.first pic only-may be physiological, but better too monitor and rule out glaucoma
dr arun, right eye optic disc shows healthy neuro retinal rim, could be normal. left eye disc shows superior notch, so confirm it with perimetry, oct and iop.
Yes dr aruṇ I ll definitely evaluate pt wd 2 nd pic
the 'RE disc appears healthy as the ISNT rule is maintained in the right eye... there appears to a superior notch in Left eye BUT it is a large disc...need more evaluation before commenting
Cases that would interest you
- Login to View the image
Fundus picture of a male patient having unilateral visual loss. Please comment!
Dr. E Ahmed1 Like21 Answers - Login to View the image
A 31 year old married male came today with a 2 month history of acute weakness in all extremities associated with paresthesia and dysesthesia. 1week ago, he suffered vision loss in the right eye and mild ocular pain. 3 days before he developed bladder dysfunction. No history of fever, headache, altered sensorium, seizures. He is a driver by occupation. Given your opinion on the Fundal images.
Dr. Gunjan Toora0 Like25 Answers - Login to View the image
56 year old hypertensive has come with complains with sudden onset loss of vision in the right eye since morning. Vision OD PL negative RAPD grade 3 Fundus picture attached 1. diagnosis 2. treatment
Dr. Neha Mehrotra3 Likes15 Answers - Login to View the image
29 years old male. complaining of suddent noticed loss of vision at his left eye since 4 days. In recent he has gor Total occlusion of ICA for which DSA was done a week back. his vision @ RE is 6/6 while left eye is CF @ 2 meters. SLE: WNL A/S. Dilated fundus examination shows multifocal pale retina. what will be the best possible management?
Dr. Sunil Uglay2 Likes21 Answers - Login to View the image
A 77 y/o female with a history of DM and HTN presented with visual loss in the left eye. Best-corrected decimal VA of 1.0 and 0.3. Light reflex of the left eye was weakened with a relative afferent pupillary defect. Fundus examination showed optic disc swelling of the left eye. Fundus image attached. Please give your comments.
Dr. Vishal Kumar1 Like18 Answers
2 Likes