Human vision and function/Part 3: Vision in real life: case studies/3.4 Mary Bastoni

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Mary Bastoni



  • are the orthoptist working at a rural Victorian hospital
  • are employed in an ophthalmology clinic
  • both you and the ophthalmologist travel to this clinic once a month and stay for 1 week


  • Mary Bastoni is a 40 year old
  • She has been referred for an ophthalmic review by the optometrist
  • She is Nick's mother and Joe Bastoni's wife and Sam Sinclair's daughter
Mary Bastoni referral letter
Mary Bastoni optic discs
Mary Bastoni visual field right eye
Mary Bastoni ophthalmic notes

Task 1

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Carefully read Mary's referral letter and ophthalmic notes. Make a note of any concepts you don't understand and discuss these with your group.

You will notice that the optometrist has enclosed a copy of the visual field of Mary's right eye. The black shaded areas are sections of her visual field that have no sight. This is linked to optic disc cupping, where the optic nerve (at the point where it enters the eye - the lamina cribrosa) is affected by high intra ocular pressure. A cup-disc ratio of 0.8 is very high - indicating pathology, whilst 0.3 (Mary's left eye) is within normal limits.

Task 2

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Consider the following questions with regards to Mary's case. Discuss each one in your group.

  1. What is glaucoma?
  2. What are some of the characteristic signs/symptoms of the disease?
  3. What are the three main types of treatment and what do they aim to achieve?
  4. What are the main issues to be aware of when using eye drops to treat glaucoma? Use this helpful resource from Glaucoma Australia.
  5. What are the prevalence rates for glaucoma in Australia?
  6. What are the predicted costs of glaucoma, in the future?

Find your own resources to answer these questions.

Task 3

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As you would have seen from Mary's ophthalmic notes, Nick accompanies his Mother today (his pupils look about 4mm!), and asks about the use of marijuana for glaucoma treatment.
What can you tell him?

Hint: Look up “Cannabinoids & Glaucoma

Other resources:
Drug facts - cannabis
Glaucoma Australia - resource 1
Glaucoma Australia - resource 2