HPD Research Day | February 16, 2018

7 Hull Auditorium 11:45 a.m. – 12:15 p.m. Juvenile Open-Angle Glaucoma: A Case Comparison Heather R. Gauger, OD, College of Optometry, Nova Southeastern University Introduction. Juvenile open-angle glaucoma typically occurs between the ages of 5 to 35 and patients are often asymptomatic with IOP of 30 mm Hg or higher. Case Presentation. Comparing and contrasting a classic case of juvenile open-angle glaucoma with an atypical case. Case 1: 13 year old Hispanic female with elevated IOPs, nerve fiber layer defects in the left eye with corresponding visual field defects as well as loss of nerve tissue in the left eye. The patient’s pachymetry proves to be thicker than average and angles are open. Case 2: 15 year old African American female with normal IOPs, abnormal nerve fiber layer defects in the right eye with corresponding loss of nerve tissue. The patient has normal corneal thickness and angles are open. Her visual fields are unreliable in both eyes. Deviation From the Expected. It is very unusual to have normal IOPs in cases of juvenile open-angle glaucoma, thus for case 2 secondary causes must be ruled out. Discussion. Case 1: IOP lowering medications were indicated. The patient will be followed up with IOP checks, visual fields, photos and OCTs. Case 2: Follow-up with repeat visual fields and IOP check. Secondary causes must be ruled out. Consult with pediatric glaucoma ophthalmologist, neuro-ophthalmologist, and patient’s PCP. Consider an MRI for completeness. Conclusion. Juvenile open-angle glaucoma can result in significant visual loss if not caught and treated early. These patients tend to present in a classical manor. When a young patient presents with nerve damage consistent with glaucoma yet normal IOP ranges, secondary causes must be ruled out. Hull Auditorium 2:15 – 2:45 p.m. Case Series: Effective Use of Microperimetry Samantha Kayser, OD, College of Optometry, Nova Southeastern University Introduction. Microperimetry is an ophthalmic diagnostic tool that correlates visual sensitivity to the exact anatomic location on the retina. While primarily used in visual rehabilitation and research, the cases presented also elucidates practical applications for primary care optometry. Case presentation. Case reports of two patients with unusual visual fields will be presented. The first patient is a 70 year old african-american female with a history of visual impairment following a CVA. The second is a 78 year old caucasian female referred for a low vision assessment status post cataract surgery that did not successfully improve visual acuity. Deviation From the Expected. This report will discuss unusual visual field deficits in patients with visual impairment and how to quantify them using microperimetry. It will also highlight how this information can be used in patient management. Discussion. The microperimeters uniquely customizable visual field program and its ability to correlate visual sensitivity to anatomic location helped gain insightful case information currently unattainable by other diagnostic tools. This data was used to guide patient management strategies. Conclusion. With recent advances in technology, there is increasing evidence supporting the utility of microperimetry as a clinical diagnostic tool and research instrument.