A 76-year-old woman was referred from optometry for glaucoma evaluation after bilateral optic nerve hemorrhages were found on a routine eye exam. The patient’s ocular history included mild hyperopia and mild dry macular degeneration.
Five years prior, the patient saw a neuro-ophthalmologist for subjective visual disturbances that included 5 seconds of “whiteout” of her bilateral central visual field while exercising. On exam at that time, she was found to have an acute posterior vitreous detachment (PVD) in the right eye, as well as nasal and superior optic nerve hemorrhages.