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  • Title: Visual-field loss with optic nerve drusen and ocular hypertension: a case report.
    Author: Spalding JM.
    Journal: Optometry; 2002 Jan; 73(1):24-32. PubMed ID: 12363235.
    Abstract:
    BACKGROUND: Patients with optic nerve drusen are often asymptomatic and free of visual symptoms. However, ocular complications such as visual-field defects may develop. This article presents the case of a patient with optic nerve drusen, ocular hypertension, and a visual-field defect. The diagnosis and management of patients with such findings will be presented. CASE REPORT: A 75-year-old man came to the eye clinic with a history of being treated for glaucoma. On examination, optic nerve drusen were found in both eyes. Subsequent testing revealed ocular hypertension and a visual-field defect that could be related to either optic nerve drusen or glaucoma. After re-establishment of baseline intraocular pressures (IOP) and re-initiation of treatment, the patient is being monitored for IOP control and visual-field progression. CONCLUSION: Optic nerve drusen and glaucoma can both cause visual-field defects. When a patient manifests optic nerve drusen, ocular hypertension, and visual-field defects, a diagnostic and management dilemma exists. Regardless of the etiology for the field defects, a treatment regimen designed to reduce the intraocular pressure to a level that potentially reduces the risk of ocular sequelae is recommended.
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