The patient is a 43-year-old female insurance sale agent who presents for her annual eye exam. She admits to symptoms of ocular irritation and burning when she wakes up in the morning. The eyes also feel dry in the afternoon and look red. She has also noted that her eyelids are of different height; noticed it when putting make-up on. She denies significant problems with driving, TV watching, computer use or reading. She also denies flashes, floaters or diplopia.
Patient admits to mild anxiety and to unexplained palpitations. Has not seen a doctor for this. Otherwise she denies any recent illness or any new CNS, heart, lungs, GI, skin or joint symptoms. Past Ocular History: Myopia. No prior eye surgeries, hx of eye trauma, amblyopia or strabismus. Ocular Exam, Visual Acuity (cc): OD: 20/20 OS: 20/20 IOP (tonoapplantation): OD: 18 mmHg OS: 16 mmHg Pupils: Equal, round and reactive to…
