Painless Vision Loss In An Elderly

Case: 67-year-old female with a history of hypertension (HTN) and diabetes (DM) who complains of gradual, painless vision loss OD and presents to the retina clinic for a second opinion in regards to her diabetic retinopathy. History of Present Illness: The patient was told by another eye clinic that nothing else could be done for her diabetic retinopathy OD. The patient reports a gradual decline in vision OD. No complaints of pain, headache, or other problems. Her blood sugars range from the 80s to 130s which she "checks weekly". PMH/FH/POH: DM treated with oral hypoglycemics and HTN treated with atenolol.

History of focal laser treatments for diabetic macular edema OD and OS. EXAM Best corrected visual acuities: 20/250 OD and 20/25 OS. Pupils: No RAPD. Confrontational VF: constricted OD and OS. EOM: Full OU. IOP: 19 mmHg OD, 22 mmHg OS Anterior segment: no iris neovascularization, 1-2+…