30 year old
Three years ago
OD 20/60 OS 20/40
Medical and ocular histories were unremarkable.
Slightly blurry vision at distance
Myopia OU and astigmatism OD with best corrected visual acuities of 20/30 OD and 20/25 OS.
Upon retinal examination, her cup to disc ratio was approximately 0.25 OU.Dot and flame hemorrhages, vessel tortuosity, and aggressive sheen were found OU as well as cotton wool spots OD. Anterior segment and IOP findings were normal and unremarkable. Due to language barrier difficulties, the patient was not able to complete the visual field screening device, but confrontation fields were normal. The patient's blood pressure was unable to be measured due to lack of a blood pressure cuff in the office, but hypertensive retinopathy was suspected.
Immediately referred for in-person exam and treatment.
Dot, Flame Hemorrhages, Blood Vessel Tortuosity
Blurry vision for several months
58 year old
Vision with current spectacles was 20/20 OD and 20/25 OS at distance, and 20/20 OD and 20/20 OS at near. The patient has hyperopia, astigmatism, and presbyopia OU and has a best corrected visual acuity of 20/20 OD and 20/20 OS.
Two years ago
OD 20/20-1 OS 20/25
Personal ocular and systemic history were unremarkable and she reported no other visual symptoms or pain.
Slit lamp exam was significant for pingueculae OU, mild arcus OU, and nuclear sclerosis OU. Pupil testing was normal. Fundus photos revealed C/D ratios of approximately 0.2 OU and tortuosity of blood vessels. Optic nerves had slightly indistinct nasal margins OU. The patient's screening visual fields were within normal limits. The patient's intraocular pressures were measured with non-contact tonometry to be about 40-51 mmHg OU with each eye tested twice.
Significantly above normal limits. The patient's prescription was put on hold and she was referred to see an ophthalmologist in-person as soon as possible to lower the intraocular pressure.
Blood Vessel Tortuosity, Slightly Indistinct nasal optic nerve margins