DR. SHIMALI PATLE

DR. ALIYA SULTANA, DR. MEGHANA JATTEPALLE

Abstract

A 30year one eyed male presented for driving license workup.Left eye was phthisical.Comprehensive exam of RE was done.Visual fields and B scan were done to diagnose.BCVA was 20/20 RE and PL negative LE. IOP was 12 mmhg in RE and 6 mmhg in LE. Anterior segment examination and pupillary light reflex of RE were normal. Fundoscopy RE showed large disc with 0.8:1CDR with central white bowel shaped OD excavation involving inferior 2/3 rd of disc with nearly absent inferotemporal neuroretinal rim with relative sparing of superior NRR. Origin of the inferior vascular bundle couldn’t be deciphered. Humphreys 24-2 visual field had superior arcuate defect, a finding ‘commonly’ described with glaucoma. Bscan had excavation of disc inferior part with overhanging and sharp edge suggesting OD coloboma. Congenital disc excavation esp.coloboma can present with 20/20 vision and commonly mistaken for glaucomatous disc. Careful disc evaluation with imaging like B scan aid in diagnosis, as in this case.