I've known Greg Ketcher OD of Lawton, OK since the old OptNet days. Here's a nice case that he recently sent, digital image and all. The words that follow are his. Thanks Greg!!

DP, a twenty seven year old, female, homemaker, presented to the optometry clinic complaining of blurry vision. Further questioning revealed that she was experiencing momentary blurring of vision which would last for less than one minute. These disturbances had been occurring in the right eye more than in the left eye and were occurring at least once per day for at least the last six months.

Past health history revealed a history of migraine headaches for the past 2-3 years. DP was not taking any medications or illicit drugs. There was no other significant past health or ocular history. There were no known drug allergies.

Confrontation visual fields were full the using finger counting method. Extraocular eye movements were smooth and intact in all fields of gaze with no diplopia or pain. Near point of convergence was 1 inch from the nose. Cover testing revealed orthophoria at distance and near. Pupils were 5 millimeters (mm) and displayed 3+ reaction to light in each eye. There was no afferent pupillary defect. All Pseudoisochromatic color plates were identified correctly in each eye. Non-contact tonometry revealed intraocular pressures of 21 OD and 20 OS at 2:35 pm.

Manifest refraction of OD -0.25 -2.25 X 180 and OS -0.25 -2.25 X 165 provided acuities of 20/20 OD, OS, and OU. Distance Van Graffe phorias were 2 exophoria horizontally and orthophoria vertically. Near visual acuity was 20/20 OD, OS, and OU with reduced Snellen. Near horizontal Van Graffe phoria was 4 exophoria. Negative relative accommodation was +2.00 (net). Positive relative accommodation was -2.50 (net).

Slit lamp biomicroscopy revealed lids and lashes free of debris. There was no ptosis or proptosis. Both conjunctiva were clear with no injection. The corneas were also clear with no neovascularization or scarring. The anterior chamber angles were graded Van Herrick 4+ nasal and temporal OU. The anterior chamber was deep centrally and contained no cells or flare. The pupils were dilated utilizing one drop of .5% proparacaine, one drop of 1% tropicamide, and one drop of 2.5% phenylephrine in each eye.

The lens and vitreous were clear. There were no vitreous cells. The examination revealed blurred, elevated disc margins OU with mild edema of the surrounding retinal tissue. Cup to disc ratio was estimated at 0.2 and round OU. There was no disc transillumination visible. Peripapillaryretinal folds were present in each eye. There were no hemorrhages, no macular edema, retinal nerve fiber layer infarcts, or lipid exudates in either eye. There was a sharp foveal reflex in each eye. The peripheral retina was flat with no holes, tears, or detachments.

What is this condition?

Thanks!