Case Studies in Ophthalmology
Cases for the Ophthalmology Clerkship
Note to Medical Students on the Ophthalmology Rotation at the University of Iowa:
Print the question and answer sheet (Ctrl-Print or Command-Print) and enter your answers on it. You may prefer to type your answers on this page and then print it. If you do this, be careful that your full answer shows in the printout. Experience with Internet Explorer has been less than optimal.
Return the printed copy with your answers to Michelle Snyder or Dr. Kemp via campus mail (11290 PFP) or scan as a pdf and email to Michelle at michelle-r-snyder@uiowa.edu or Dr. Kemp at pavlina-kemp@uiowa.edu.
Case #19 Angle Closure Glaucoma
History
This 71-year-old gentleman presents with a history of acute pain in the right eye with nausea and vomiting.
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Question #1
What accounts for the dull and broken up light reflex on the patient's cornea?
Question #2
Is this patient more likely to be near-sighted (myopic) or far-sighted (hyperopic)?
Question #3
If this patient had intermittent episodes of elevated pressure in the past, what symptoms might he have noted other than discomfort?
Question #4
What is the medical therapy in a case presenting acutely? Is the definitive therapy for this condition medical or surgical?
Question #5
Is there any significant risk of a similar condition developing in the contralateral eye?
References
Shields, MB:Textbook of Glaucoma. Baltimore: Williams and Wilkins, 1987: 165-181.