All in All Anterior to Posterior Segment Ocular Diseases in a Single Individual

Abstract

Significance: Anterior to posterior ocular diseases in the eye is possible, although rare. Visual disturbances and ocular discomfort may contribute to several factors. Purpose: The purpose of this case report was to describe the possibility of multiple ocular diseases that may present in the eye, making it imperative for optometrists to perform a comprehensive eye examination daily. Case report: A 57-year-old, female presented with a severe gritty sensation in the right eye. The patient underwent Laser Assisted In-situ Keratomileusis (LASIK) 30 years ago and her medical history reveals newly diagnosed Hypertension. The patient has mild bilateral blepharoptosis, and on slit lamp examination with fluorescein staining, the ocular surface reveals multiple Superficial Punctate Keratitis (SPK) possibly due to Post-LASIK. Further, mild clouding of the crystalline lenses was noted suggestive of Nuclear Sclerosis (NS). Dilated eye examination, reveals tiny multiple yellowish-white reflecting particles which were Asteroid Hyalosis (AH) and flame-shaped hemorrhages extended from the optic disc to the macula that is suggestive of Central Retinal Vein Occlusion (CRVO). All in all anterior to posterior segment ocular diseases in this patient were managed accordingly by Optometrist and Ophthalmologist. The diagnosis made were bilateral aponeurotic ptosis, severe dry eyes, NS, AH, and CRVO. The patient was treated with topical cyclosporine and Anti-vasular endothelial growth factor (anti-VEGF) scheduled. Conclusion: This case demonstrates the role of patient history, clinical findings, diagnosis, and treatment of blepharoptosis, chronic dry eye, NS, AH, and CRVO. It emphasizes the importance of evaluating the anterior to posterior segment ocular structures and managing such cases requires close collaboration and teamwork with ophthalmologists. Careful examination and systemic evaluation are vital in such a scenario. It is important to educate patients that any sudden vision loss is not normal and they should consult an eye care professional immediately.