Figure 1. Left drance haemorrhage (arrow)
Dr Alan Burrow
MOptom FBOA(HD) FBCO DOrth DCLP MSc(Med) GCOT GCBA
Coffs Harbour, NSW
A 78-year-old female patient reported for a routine eye examination. The intraocular pressures were right 18 mmHg and left 19 mmHg. Both anterior chamber angles were open. There was a left drance haemorrhage, as illustrated by the arrow in Figure 1.
The visual field analysis demonstrated an arcuate field defect. The OCT scan displayed thinning of the retinal nerve fibre layer. Both defects were consistent with the location of the haemorrhage.
The diagnosis was normal tension glaucoma. Treatment was commenced with Xalatan but subsequently modified to Xalacom, which reduced the IOP to right 13 mmHg and left 15 mmHg.
Figure 2. RNFL thinning
Figure 3. Arcuate field defect