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44-year-old man was seen in the office on 6/26/2009. He was admitted to the hospital about a month ago. He was diagnosed with HIV and he had pneumonia. He was placed on drugs, he thinks ganciclovir. He has had blurred vision for about a month, more in the left eye than the right eye. He was diagnosed at one point with corneal edema in the left eye. He notices his vision in the right eye is hazy. He is currently on Pred Forte in the left eye four times a day which seems to be helping his vision some in the left eye, but the right eye is still not seeing that well. He has not yet seen anyone to start anti-AIDS therapy. He was given a medical doctor's name for a follow-up visit. He thinks his CD4 count is somewhere in the low 100s. VISUAL ACUITY: Vision OU is 20/30. IOP: OD 19, OS 17. AMSLER GRID: Normal in both eyes. SLIT LAMP EXAM: The right eye has 3+ irregularities of the corneal endothelium. There is 2+ cell and flare of the anterior chamber. The lens is clear. The left eye has 2+ corneal edema, 3+ endotheliitis, and 2+ cell and flare of the anterior chamber with a clear lens. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.1. There are 2+ vitreous cells. There is extensive CNV retinitis which looks to have been burned out and treated, extending from 12:00 o’clock all the way around to 9:00 o’clock and sparing the macula, stopping about 2-disc diameters short of the macula and the optic nerve. OS: Vertical C/D ratio is 0.1. It is difficult to see the retina because of the corneal edema. He does have cotton-wool spots around the optic nerve. I do not see any CNV retinitis. PHOTOGRAPHS: Photos confirm clinical findings. IMPRESSION: 1. BILATERAL UVEITIS 2. ENDOTHELIITIS – LEFT EYE 3. CNV RETINITIS – RIGHT EYE Page 2-- Michael Ruffin (5/12/1965) June 30, 2009 DISCUSSION: I explained to the patient all of his symptoms are consistent with herpes infection of the retina and the cornea. I suggested he start oral Valcyte, 450 mg, two p.o. b.i.d., and he will see the medical doctor on Monday. The sooner he can start on anti-AIDS treatment, the sooner his CD4 count will improve and the retinitis will come under control. Patient never returned for any appointments

cmvpariallytreatedaids_28429.jpg
Cytomegalovirus Retinitis - Partially Treated and AIDS retinopathy121 views44-year-old man a month agoe was diagnosed with HIV and he had pneumonia. He has had blurred vision for about a month, more in the left eye than the right eye. He has not yet seen anyone to start anti-AIDS therapy. He was given a medical doctor's name for a follow-up visit. He thinks his CD4 count is somewhere in the low 100s. Vision OU is 20/3000000
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Cytomegalovirus Retinitis - Partially Treated and AIDS retinopathy122 views44-year-old man a month agoe was diagnosed with HIV and he had pneumonia. He has had blurred vision for about a month, more in the left eye than the right eye. He has not yet seen anyone to start anti-AIDS therapy. He was given a medical doctor's name for a follow-up visit. He thinks his CD4 count is somewhere in the low 100s. Vision OU is 20/3000000
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Cytomegalovirus Retinitis - Partially Treated and AIDS retinopathy118 views44-year-old man a month agoe was diagnosed with HIV and he had pneumonia. He has had blurred vision for about a month, more in the left eye than the right eye. He has not yet seen anyone to start anti-AIDS therapy. He was given a medical doctor's name for a follow-up visit. He thinks his CD4 count is somewhere in the low 100s. Vision OU is 20/3000000
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cmvpariallytreatedaids_28229.jpg
Cytomegalovirus Retinitis - Partially Treated and AIDS retinopathy91 views44-year-old man a month agoe was diagnosed with HIV and he had pneumonia. He has had blurred vision for about a month, more in the left eye than the right eye. He has not yet seen anyone to start anti-AIDS therapy. He was given a medical doctor's name for a follow-up visit. He thinks his CD4 count is somewhere in the low 100s. Vision OU is 20/3000000
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Cytomegalovirus Retinitis - Partially Treated and AIDS retinopathy114 views44-year-old man a month agoe was diagnosed with HIV and he had pneumonia. He has had blurred vision for about a month, more in the left eye than the right eye. He has not yet seen anyone to start anti-AIDS therapy. He was given a medical doctor's name for a follow-up visit. He thinks his CD4 count is somewhere in the low 100s. Vision OU is 20/3000000
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44-year-old man was seen in the office on 6/26/2009. He was admitted to the hospital about a month ago. He was diagnosed with HIV and he had pneumonia. He was placed on drugs, he thinks ganciclovir. He has had blurred vision for about a month, more in the left eye than the right eye. He was diagnosed at one point with corneal edema in the left eye. He notices his vision in the right eye is hazy. He is currently on Pred Forte in the left eye four times a day which seems to be helping his vision some in the left eye, but the right eye is still not seeing that well. He has not yet seen anyone to start anti-AIDS therapy. He was given a medical doctor's name for a follow-up visit. He thinks his CD4 count is somewhere in the low 100s. VISUAL ACUITY: Vision OU is 20/30. IOP: OD 19, OS 17. AMSLER GRID: Normal in both eyes. SLIT LAMP EXAM: The right eye has 3+ irregularities of the corneal endothelium. There is 2+ cell and flare of the anterior chamber. The lens is clear. The left eye has 2+ corneal edema, 3+ endotheliitis, and 2+ cell and flare of the anterior chamber with a clear lens. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.1. There are 2+ vitreous cells. There is extensive CNV retinitis which looks to have been burned out and treated, extending from 12:00 o’clock all the way around to 9:00 o’clock and sparing the macula, stopping about 2-disc diameters short of the macula and the optic nerve. OS: Vertical C/D ratio is 0.1. It is difficult to see the retina because of the corneal edema. He does have cotton-wool spots around the optic nerve. I do not see any CNV retinitis. PHOTOGRAPHS: Photos confirm clinical findings. IMPRESSION: 1. BILATERAL UVEITIS 2. ENDOTHELIITIS – LEFT EYE 3. CNV RETINITIS – RIGHT EYE Page 2-- Michael Ruffin (5/12/1965) June 30, 2009 DISCUSSION: I explained to the patient all of his symptoms are consistent with herpes infection of the retina and the cornea. I suggested he start oral Valcyte, 450 mg, two p.o. b.i.d., and he will see the medical doctor on Monday. The sooner he can start on anti-AIDS treatment, the sooner his CD4 count will improve and the retinitis will come under control. Patient never returned for any appointments