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35-year-old man was seen in the office on January 6, 2010. He has had hazy vision in his left eye for about the last three days. He has had no surgery and he has no history of surgery. He has not had to his knowledge had any problems with any clotting disorders or bleeding disorders. VISUAL ACUITY: OD 20/20, OS 20/30. IOP: OD 12, OS 14. SLIT EXAMINATION: Normal with clear lenses. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.6. There is no posterior vitreous separation. The macula and periphery look healthy. OS: Vertical C/D ratio is 03. There is an inferior hemi central retinal vein occlusion. There is 2+ macular edema, mostly on the inferior edge of the macula. There are patchy retinal hemorrhages. The inferior retinal veins are dilated. The superior retinal veins look normal. Photos confirm clinical findings. FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows delayed filling of the inferior branch of the central retinal vein starting within the border of the optic nerve with fluorescein leakage into the fovea in the late frames. There is patchy hypofluorescence corresponding to the hemorrhages, which are minimal. IMPRESSION: 1. INFERIOR HEMI CENTRAL RETINAL VEIN OCCLUSION – LEFT EYE 2. MACULAR EDEMA - LEFT EYE DISCUSSION: I explained to the patient he does have a retinal vein occlusion in the left eye. The odds are excellent that this will heal itself. About 90% of people with retinal vein occlusions, who begin with good vision, maintain good vision. He does need to be followed though. I asked him to return here for a check in six weeks or sooner should he notice a problem and see you back regularly. Because he is so young, it would be prudent to obtain a blood test on him to screen him for possible coagulopathies and I will send a note to his medical doctor to that affect. NOTE: patient never followed up with medical doctor for testing or with us until he lost vision from a vitreous hemorrhage 8 months later. He is now being treated for that (November 2010)

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Hemi Central Retinal Vein Occlusion 35 year old non-compliant man275 views35-year-old man hazy vision in his left eye for about the last three days. OD 20/20, OS 20/3000000
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Hemi Central Retinal Vein Occlusion 35 year old non-compliant man186 views35-year-old man hazy vision in his left eye for about the last three days. OD 20/20, OS 20/3000000
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Hemi Central Retinal Vein Occlusion 35 year old non-compliant man124 views35-year-old man hazy vision in his left eye for about the last three days. OD 20/20, OS 20/3000000
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Hemi Central Retinal Vein Occlusion 35 year old non-compliant man124 views35-year-old man hazy vision in his left eye for about the last three days. OD 20/20, OS 20/3000000
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Hemi Central Retinal Vein Occlusion 35 year old non-compliant man119 views35-year-old man hazy vision in his left eye for about the last three days. OD 20/20, OS 20/3000000
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Hemi Central Retinal Vein Occlusion 35 year old non-compliant man61 views35-year-old man hazy vision in his left eye for about the last three days. OD 20/20, OS 20/3000000
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Hemi Central Retinal Vein Occlusion 35 year old non-compliant man84 views35-year-old man hazy vision in his left eye for about the last three days. OD 20/20, OS 20/3000000
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Hemi Central Retinal Vein Occlusion 35 year old non-compliant man87 views35-year-old man hazy vision in his left eye for about the last three days. OD 20/20, OS 20/3000000
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Hemi Central Retinal Vein Occlusion 35 year old non-compliant man118 views35-year-old man hazy vision in his left eye for about the last three days. OD 20/20, OS 20/3000000
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Hemi Central Retinal Vein Occlusion 35 year old non-compliant man74 views35-year-old man hazy vision in his left eye for about the last three days. OD 20/20, OS 20/3000000
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Hemi Central Retinal Vein Occlusion 35 year old non-compliant man134 views35-year-old man hazy vision in his left eye for about the last three days. OD 20/20, OS 20/3000000
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35-year-old man was seen in the office on January 6, 2010. He has had hazy vision in his left eye for about the last three days. He has had no surgery and he has no history of surgery. He has not had to his knowledge had any problems with any clotting disorders or bleeding disorders. VISUAL ACUITY: OD 20/20, OS 20/30. IOP: OD 12, OS 14. SLIT EXAMINATION: Normal with clear lenses. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.6. There is no posterior vitreous separation. The macula and periphery look healthy. OS: Vertical C/D ratio is 03. There is an inferior hemi central retinal vein occlusion. There is 2+ macular edema, mostly on the inferior edge of the macula. There are patchy retinal hemorrhages. The inferior retinal veins are dilated. The superior retinal veins look normal. Photos confirm clinical findings. FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows delayed filling of the inferior branch of the central retinal vein starting within the border of the optic nerve with fluorescein leakage into the fovea in the late frames. There is patchy hypofluorescence corresponding to the hemorrhages, which are minimal. IMPRESSION: 1. INFERIOR HEMI CENTRAL RETINAL VEIN OCCLUSION – LEFT EYE 2. MACULAR EDEMA - LEFT EYE DISCUSSION: I explained to the patient he does have a retinal vein occlusion in the left eye. The odds are excellent that this will heal itself. About 90% of people with retinal vein occlusions, who begin with good vision, maintain good vision. He does need to be followed though. I asked him to return here for a check in six weeks or sooner should he notice a problem and see you back regularly. Because he is so young, it would be prudent to obtain a blood test on him to screen him for possible coagulopathies and I will send a note to his medical doctor to that affect. NOTE: patient never followed up with medical doctor for testing or with us until he lost vision from a vitreous hemorrhage 8 months later. He is now being treated for that (November 2010)