[Skip to Navigation]
Views 1,263
Citations 0
JAMA Ophthalmology Clinical Challenge
September 10, 2020

Progressive Vision Loss in a 62-Year-Old Woman

Author Affiliations
  • 1University of Miami Miller School of Medicine, Bascom Palmer Eye Institute, Department of Ophthalmology, Miami, Florida
JAMA Ophthalmol. 2020;138(11):1207-1208. doi:10.1001/jamaophthalmol.2020.1746

A 62-year-old woman with a history of chronic angle-closure glaucoma and bilateral peripheral iridotomies sought a second opinion for worsening visual acuity in the left eye for 2 months. She had been treated for glaucoma for approximately 1 year. Review of systems was negative for previous episodes of eye pain, redness, or emesis. Her medical history included hyperlipidemia, obesity, and prior cataract surgery in both eyes. On examination, best-corrected visual acuity was 20/20 OD and 20/80 OS. The patient’s pupils were equal, round, and reactive to light without a relative afferent pupillary defect. Intraocular pressure was 11 mm Hg bilaterally without medication. Slitlamp findings were notable for patent peripheral iridotomies, open angles on gonioscopy, and an asymmetrically enlarged cup-disc ratio with mild pallor of the left optic nerve. Color vision was decreased in the left eye. Visual field (VF) testing as well as ganglion cell layer (GCL) segmentation by optical coherence tomography (OCT) were obtained for both eyes (Figure 1).

Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words