A 35 year old male, otherwise asymptomatic presented for some travel induced irritation of his eyes.
his 6/6 vision in both eyes;
but
cupping of 0.8 in RE and 0.9 in LE, NRR thin but no notching. No obvious nerve fibre defect seen.
IOP 14 mm applanation in both eyes;
normal fields both eyes.
Gonio open in all quadrants.
No history whatsoever suggestive of intermittant angle closure.
In other words, all parameters except disc are normal.
He had been seen 3 years ago at Tadepalligudem, and apparently his condition was exactly the same even then including vision and fields.

Any explanation for this isolated disc picture, a rather alarming but apparently innocuous cupping with no other supporting symptoms/ signs of glaucoma?

Dear Doctor,
Thank you for query. Its been posted to the expert panel. Will get to you as soon as we gets the response.

Dr.Anil Kumar Bathua

Dear Dr Sarveswara Rao

I would like to know the size of the Optic Disc. From the details available ..the patient seems to be having large physiological cupping - which does not require any treatment.

He however needs to be followed up regularly . For now - He can be treated with lubricants for his ocular irritation.

Would it be however be possible for you to upload or mail me the disc photos ?


Regards

Will try. The patient may not be able to afford most of the otherwise desirable investigations. Will try disc photographs. I have the fields, though.

Dear Dr Kalyani,
I have uploaded the patient's fundus photographs and fields. I acknowledge and appreciate the gesture of Mr G Ranjit Kumar of GRK VIsual Fields Analysing Centre, Panjagutta in providing the fundus photographs without any charge to the patient. Thanks, Mr Ranjit.

Dear Dr Anil
I have uploaded disc pictures as suggested by Dr Kalyani.
T S Rao