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Photo Essay
August 2007

Megalopapilla, Not Glaucoma

Arch Ophthalmol. 2007;125(8):1134. doi:10.1001/archopht.125.8.1134

An 8-year-old white boy was referred to us for glaucoma evaluation. He had no history of premature birth or systemic anomalies. He was asymptomatic, with a visual acuity of 20/20 OU, an intraocular pressure of 12 mm Hg OU, and normal visual fields in both eyes (Figure 1). Ophthalmoscopy revealed a cup-disc ratio of 0.8 with mild cup pallor in both eyes (Figure 2). Heidelberg retinal tomography (Figure 3) and optical coherence tomography with normal nerve fiber layer thickness confirmed the diagnosis of megalopapilla type 1.1,2

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