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This pleasant 72-year-old man was seen in the office on 10/1/2010. He noticed decreased vision in the right eye on Tuesday, which was three days ago. It started like a teardrop in the inferonasal visual field, which subsequently crept over to a shadow which is now hanging over his vision. The vision in the left eye is fine. That eye did have a vitrectomy for vitreous opacities in October of 2008. He had cataract surgery in the eye in January of 2007 and subsequently had YAG capsulotomy. He has not had anything done to his eyes lately. VISUAL ACUITY: Vision OD is 1/200, OS is 20/20. IOP: OD 19, OS 14. SLIT LAMP EXAM: The posterior chamber intraocular lens is in good position in both eyes. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.7. There is a macula-off retinal detachment extending from 8:00 o’clock around to 2:00 o’clock with a retinal break just posterior to the equator at 11:00 o’clock. OS: Vertical C/D ratio is 0.7. The macula and periphery look healthy. IMPRESSION: 1. MACULA-OFF RETINAL DETACHMENT – RIGHT EYE 2. RETINAL TEAR – RIGHT EYE DISCUSSION: I explained to the patient with pneumatic retinopexy there is about a 90% chance of reattaching his retina. Because of his previous vitrectomy, it is possible in his eye to do a fluid-gas exchange in the office. I anesthetized his eye with retrobulbar anesthetic, as well as subconjunctival anesthetic. I treated the area of the retinal break with cryotherapy and then I did a fluid-gas exchange with 16% SF6 gas. He does have glaucoma, so I used the nonexpansile concentration. I asked him to position mostly sitting up during the day, left-side-down at night, and he knows to be looking towards the floor at least a little bit. In addition, for the next two days, he will be doing face-down positioning for ten or fifteen minutes every hour or two. He will return to the office on Monday, sooner should he notice increased pain or decreased vision. I asked him to leave the patch on overnight and he will be seeing you back periodically as well.

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post retinal detachment repair207 views72-year-old with a history of retinal detachment in the right eye. He had pneumatic retinopexy followed by panretinal laser. He returns today reporting that he is seeing fairly well but the central vision in the right eye is not as clear as it used to be.

OPHTHALMIC EXAM: Visual acuity with correction of 20/100 OD, 20/20 OS; PH 20/80 OD. IOP: 18 OD.

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This pleasant 72-year-old man was seen in the office on 10/1/2010. He noticed decreased vision in the right eye on Tuesday, which was three days ago. It started like a teardrop in the inferonasal visual field, which subsequently crept over to a shadow which is now hanging over his vision. The vision in the left eye is fine. That eye did have a vitrectomy for vitreous opacities in October of 2008. He had cataract surgery in the eye in January of 2007 and subsequently had YAG capsulotomy. He has not had anything done to his eyes lately. VISUAL ACUITY: Vision OD is 1/200, OS is 20/20. IOP: OD 19, OS 14. SLIT LAMP EXAM: The posterior chamber intraocular lens is in good position in both eyes. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.7. There is a macula-off retinal detachment extending from 8:00 o’clock around to 2:00 o’clock with a retinal break just posterior to the equator at 11:00 o’clock. OS: Vertical C/D ratio is 0.7. The macula and periphery look healthy. IMPRESSION: 1. MACULA-OFF RETINAL DETACHMENT – RIGHT EYE 2. RETINAL TEAR – RIGHT EYE DISCUSSION: I explained to the patient with pneumatic retinopexy there is about a 90% chance of reattaching his retina. Because of his previous vitrectomy, it is possible in his eye to do a fluid-gas exchange in the office. I anesthetized his eye with retrobulbar anesthetic, as well as subconjunctival anesthetic. I treated the area of the retinal break with cryotherapy and then I did a fluid-gas exchange with 16% SF6 gas. He does have glaucoma, so I used the nonexpansile concentration. I asked him to position mostly sitting up during the day, left-side-down at night, and he knows to be looking towards the floor at least a little bit. In addition, for the next two days, he will be doing face-down positioning for ten or fifteen minutes every hour or two. He will return to the office on Monday, sooner should he notice increased pain or decreased vision. I asked him to leave the patch on overnight and he will be seeing you back periodically as well.