68-year-old woman that I saw in the office on December 1, 2008. She has noticed floaters in her right eye for about ten days and over Thanksgiving. Then she noticed a veil over her vision just the last few days. She had cataract surgery a year ago. VISUAL ACUITY: OD 20/200, OS 20/40. IOP: OD 16, OS 14. SLIT EXAMINATION: Posterior chamber intraocular lens is in good position in both eyes. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.5. There is 2+ vitreous cells. There is a superior retinal detachment with a large retinal tear at 1 o’clock. The macula is detached or split by the detachment. The retinal detachment extends from 10 o’clock to 2 o’clock. There are no other tears or detachments. There is a 1+ inferior vitreous hemorrhage. OS: Vertical C/D ratio is 0.5. There is posterior vitreous separation. With scleral depression, there are no tears. IMPRESSION: 1. RETINAL DETACHMENT – RIGHT EYE 2. RETINAL TEAR – RIGHT EYE 3. VITREOUS HEMORRHAGE – RIGHT EYE 4. VITREOUS SEPARATION – RIGHT EYE DISCUSSION: I explained to the patient that the right eye unfortunately does have a retinal detachment and a pneumatic retinopexy, there is an eighty to ninety percent chance of reattaching the retina. Her retinal break is large, I am a little concerned about the bubble going through the break. I numbed her eye with a heavy subconjunctival anesthetic and then I did cryotherapy around the retinal break. I injected her with a bubble and rolled her head around in such a way that the bubble would fall into the macula and then she maintained positioning in the office for a few minutes and I gently rolled her superiorly and I checked the break and the retina flattened out almost completely. One year later vision 20/30! |
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68-year-old woman that I saw in the office on December 1, 2008. She has noticed floaters in her right eye for about ten days and over Thanksgiving. Then she noticed a veil over her vision just the last few days. She had cataract surgery a year ago. VISUAL ACUITY: OD 20/200, OS 20/40. IOP: OD 16, OS 14. SLIT EXAMINATION: Posterior chamber intraocular lens is in good position in both eyes. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.5. There is 2+ vitreous cells. There is a superior retinal detachment with a large retinal tear at 1 o’clock. The macula is detached or split by the detachment. The retinal detachment extends from 10 o’clock to 2 o’clock. There are no other tears or detachments. There is a 1+ inferior vitreous hemorrhage. OS: Vertical C/D ratio is 0.5. There is posterior vitreous separation. With scleral depression, there are no tears. IMPRESSION: 1. RETINAL DETACHMENT – RIGHT EYE 2. RETINAL TEAR – RIGHT EYE 3. VITREOUS HEMORRHAGE – RIGHT EYE 4. VITREOUS SEPARATION – RIGHT EYE DISCUSSION: I explained to the patient that the right eye unfortunately does have a retinal detachment and a pneumatic retinopexy, there is an eighty to ninety percent chance of reattaching the retina. Her retinal break is large, I am a little concerned about the bubble going through the break. I numbed her eye with a heavy subconjunctival anesthetic and then I did cryotherapy around the retinal break. I injected her with a bubble and rolled her head around in such a way that the bubble would fall into the macula and then she maintained positioning in the office for a few minutes and I gently rolled her superiorly and I checked the break and the retina flattened out almost completely. One year later vision 20/30!
