Case 12-18. Generalized Depression

Clinical Summary

An 87-year-old white man with pseudoexfoliation glaucoma had an intraocular pressure of 27 mm Hg and a visual acuity of 20/30 in his right eye. 1 le had been taking carteolol 1% twice daily in this eye. Slit-lamp examination revealed pseudoexfoliation and 2-3+ nuclear sclerosis of the crystalline lens. Dilated ophthalmoscopy (AJ showed a moderately cupped optic disc and slight superotemporal attenuation of the neuroretinal rim. A Humphrey visual field (C) showed generalized depression with evidence of an inferior nasal step.

Optical Coherence Tomography

The circular OCT image (D) showed a generalized decrease in nerve fiber layer thickness throughout the image, consistent with the depressed field. A focal area of more relative thinning was observed on OCT superotem-porally at 11:00, corresponding to the relative inferonasal field defect.

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