An 11-year-old boy was asymptomatic until he failed a vision screening test for school football. After being evaluated by a local vitreoretinal specialist he was referred for further evaluation and treatment at an advanced ophthalmology hospital. No previous family history of vision problem was noted.
Past Ocular History: Two years earlier the patient was diagnosed by his school nurse that the vision in his left eye was not as good as his right eye. The patient was encouraged to visit a local ophthalmologist but did not follow-up. Present Ocular Exam: Visual Acuity: OD: 20/15; OS: 20/300 PH NI Pupils: OD: 5→ 3; OS: 5→ 4 with > 1.8 log unit relative afferent pupillary defect Extraocular Motility: Full in diagnostic positions of gaze Confrontation Visual Fields: Full OD & OS Intraocular Pressure: OD: 21; OS: 17 External and Anterior Segment Exams: Unremarkable Dilated fundus exam and…
