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I was having a debate with one of my colleages (a former classmate from my graduating class). The debate revolved around whether or not a commerical optometrist should treat ocular disease in the following situation:
a) The optometrist in the establishment has obtained 2-3 baseline VF's (24-2) in order to ascertain a reliable VF. In addition, they have 2-3 IOP measurements with pachy. readings. Through dilation and evaluation of the ON head, they conclude that there is evident nerve fiber loss, and along with VF nasal steps in each eye, and IOP's in the 30's, the doctor starts the pt on a glc drop trial to lower down the pressure. RTC 1 week.
b) The same situation as in A, however, the doctor does not start the pt on drops and sends them off because they do not have an OCT/GDX.
I argued A because, even though an OCT or GDX provides more information, the correlation between appearance of ON and VF, as well as high IOP's would lead me to a dx.
I'm curious as to other opinions on this.
Thanks
a) The optometrist in the establishment has obtained 2-3 baseline VF's (24-2) in order to ascertain a reliable VF. In addition, they have 2-3 IOP measurements with pachy. readings. Through dilation and evaluation of the ON head, they conclude that there is evident nerve fiber loss, and along with VF nasal steps in each eye, and IOP's in the 30's, the doctor starts the pt on a glc drop trial to lower down the pressure. RTC 1 week.
b) The same situation as in A, however, the doctor does not start the pt on drops and sends them off because they do not have an OCT/GDX.
I argued A because, even though an OCT or GDX provides more information, the correlation between appearance of ON and VF, as well as high IOP's would lead me to a dx.
I'm curious as to other opinions on this.
Thanks