The Quiet Quadrant
neuro ophthalmology
Patient Demographics
Age: 64 years
Gender: Female
History of Presenting Complaint
Attends for routine visual field assessment as part of ongoing monitoring for chronic (primary open-angle) glaucoma. No new visual symptoms volunteered. Specifically denies any awareness of visual field loss and reports never bumping into objects or furniture.
Past Medical History
- Known arteriopath — previous cardiac stenting
- Longstanding amblyopia, right eye, since childhood
- Chronic simple (primary open-angle) glaucoma — established diagnosis, under routine follow-up
Examination Findings
Visual Acuity
OD: Hand Movements (HM) — longstanding amblyopia, unchanged from baseline. OS: 6/6
Pupils
Equal and reactive, no RAPD
Extraocular Movements
Full both eyes
Anterior Segment
Unremarkable bilaterally
Posterior Segment
OD — optic disc unremarkable; longstanding amblyopic eye, no acute pathology. OS — optic disc shows an asymmetric cup with superior neuroretinal rim notching.
Intraocular Pressure
OD 15mmHg, OS 16mmHg (within treated target range)
Which investigations would you choose?
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Automated visual field testing
MRI brain
OCT optic disc / RNFL
Fluorescein angiography
Temporal artery biopsy
0 of 3 investigations selected
Investigations (Locked)
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