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63-year-old woman who I saw in the office on June 17, 2009. I saw her for a Stage 3 macular hole in her left eye in July of 2007. She had at that time a Stage 0 macular hole in the right eye. The macular hole in the left eye self sealed, her vision improved and then starting about six weeks ago the vision in the right eye began to decline. She noticed difficulty reading. You saw a macular hole and suggest that she come in her for an evaluation. VISUAL ACUITY: OD 20/200, OS 20/40. IOP: OD 16, OS 17. SLIT EXAMINATION: The posterior chamber intraocular lens is in good position in both eyes. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.2. There is no posterior vitreous separation. There is a Stage 3 macular hole with a 1+ epiretinal membrane. OS: Vertical C/D ratio is 0.2. There is a partial posterior vitreous separation. The macula is flat and dry. The hole is closed. There is an area of congenital hypertrophy with a retinal pigment epithelium inferiorly, which is about 7 mm across. Photos confirm clinical findings. IMPRESSION: 1. STAGE 3 MACULAR HOLE – RIGHT EYE 2. SELF SEALED MACULAR HOLE – LEFT EYE 3. CONGENITAL HYPERTROPHY WITH A RETINAL PIGMENT EPITHELIUM – LEFT EYE DISCUSSION: I explained to the patient she does have a macular hole in the right eye and with surgery there is an excellent chance of closing the hole and improving the vision. It is possible that this will spontaneously close, but I think unlikely. Her schedule is busy and she has family visiting in July and hopefully there will be no harm in waiting till August for reevaluation, then probable surgery. I explained to her that nowadays if we use long-acting gas there is no need to position, other than avoiding face up positioning after the surgery. She will probably go ahead with the surgery in August. I will have her see you back regularly.

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Congenital Hypertrophy of the Retinal Pigment Epithelium196 views00000
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Congenital Hypertrophy of the Retinal Pigment Epithelium466 views11111
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63-year-old woman who I saw in the office on June 17, 2009. I saw her for a Stage 3 macular hole in her left eye in July of 2007. She had at that time a Stage 0 macular hole in the right eye. The macular hole in the left eye self sealed, her vision improved and then starting about six weeks ago the vision in the right eye began to decline. She noticed difficulty reading. You saw a macular hole and suggest that she come in her for an evaluation. VISUAL ACUITY: OD 20/200, OS 20/40. IOP: OD 16, OS 17. SLIT EXAMINATION: The posterior chamber intraocular lens is in good position in both eyes. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.2. There is no posterior vitreous separation. There is a Stage 3 macular hole with a 1+ epiretinal membrane. OS: Vertical C/D ratio is 0.2. There is a partial posterior vitreous separation. The macula is flat and dry. The hole is closed. There is an area of congenital hypertrophy with a retinal pigment epithelium inferiorly, which is about 7 mm across. Photos confirm clinical findings. IMPRESSION: 1. STAGE 3 MACULAR HOLE – RIGHT EYE 2. SELF SEALED MACULAR HOLE – LEFT EYE 3. CONGENITAL HYPERTROPHY WITH A RETINAL PIGMENT EPITHELIUM – LEFT EYE DISCUSSION: I explained to the patient she does have a macular hole in the right eye and with surgery there is an excellent chance of closing the hole and improving the vision. It is possible that this will spontaneously close, but I think unlikely. Her schedule is busy and she has family visiting in July and hopefully there will be no harm in waiting till August for reevaluation, then probable surgery. I explained to her that nowadays if we use long-acting gas there is no need to position, other than avoiding face up positioning after the surgery. She will probably go ahead with the surgery in August. I will have her see you back regularly.