Amblyopia Masks Fundus Changes
Edited by Walt Mayo, O.D.
A 12-year-old white male presents for annual examination with no complaints, but with a history of vision therapy to treat amblyopia in the right eye. Personal and family medical histories are unremarkable. There is no family history of eye disease or blindness.
How would you approach this case? Read on for further details about the visit. Then test your clinical skills by clicking here. It is Case No. 104.
Uncorrected visual acuity is 20/30 O.D. and 20/20 O.S. Neither pinhole testing nor refraction is successful in improving the visual acuity O.D.,and no significant anisometropia is detected.
Cover testing reveals orthophoria at distance and slight exophoria at near. Extraocular motilities are full, smooth and comitant. Pupils are equal and react briskly to direct and consensual light stimuli, with absence of afferent pupillary defect.
Anterior segment evaluation is unremarkable. A dilated fundus examination reveals the clinical appearance seen in the accompanying fundus photograph. Subsequent visual field testing reveals centrocecal scotoma involving fixation O.D.
What is your diagnosis? How would you manage this patient? Are there any additional tests that you would like to perform?
For answers, follow the instructions in the box below.
Case contributed by Susannah Marcus, O.D.
Dr. Mayo, a private practitioner in Georgetown, S.C., is technology director for the Southern Council of Optometrists. You may contact him at waltmayo@aol.com or waltmayo@sccoast.net.
[]
[Optometric Study Center]
[Managed Care Library]
[] [Optometric Resources] [About RO] [Search]
