Retinopathy of Prematurity - Cicatricial - Macular Fold - Pseudo-RP
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60-year-old woman was seen in the office on October 2, 2008. She was born with retinopathy prematurity. She was born at 6 pounds but then she was incubated and she had difficulty with her eye subsequent to that. She had cataract surgery done about 20 years ago. One surgery of the eye was done at West Florida, the other at St. Luke’s, and then she developed dislocation intraocular lens in the right eye. You removed the intraocular lens and put an anterior chamber intraocular lens in that eye in March of 2006. Subsequent to that she was doing very well with the right eye until about two or three months ago when she starting noticing halos and difficulty with her vision in that eye and shadows. You suggested she come in here for an evaluation for what to do about the right eye. She was worried the lens might have shifted.
VISUAL ACUITY: OD 8/200, OS 1/200. IOP: OD 14, OS 9.
SLIT LAMP EXAM: The right eye has an irregular iris. There is a superior iridectomy. The pupil is slightly ectopic. The anterior chamber intraocular lens does look dislocated slightly superiorly. The visual axis is still well within the optic but the haptics are slightly dislocated superiorly. The left eye has a posterior chamber intraocular lens which is mobile but still centered.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.0. There is a macular fold with extensive chorioretinal scarring throughout the retina.
OS: Vertical C/D ratio is 0.0. There is a macular fold and peripheral retinal folds. There is extensive chorioretinal scarring.
IMPRESSION:
1. NEW SYMPTOM OF HALOS AND VISION CHANGE – RIGHT EYE
2. SLIGHTLY DISLOCATED ANTERIOR CHAMBER INTRAOCULAR LENS – RIGHT EYE
3. MOBILE POSTERIOR CHAMBER INTRAOCULAR LENS – LEFT EYE
4. EXTENSIVE CHORIORETINAL SCARRING FOR RETINOPATHY PREMATURITY WITH RETINAL FOLDS IN THE MACULA – BOTH EYES
DISCUSSION: I explained to the patient the right intraocular lens has shifted slightly superiorly. However, the visual axis is still well within the optic and I suggested that she wait a month or two to see if the new symptoms might abate. Sometimes patients will adapt to changes in their vision and the symptoms have become less bothersome and even completely subside without any necessary surgery. I told her I could either reposition the anterior chamber intraocular lens in the eye, which may work but may not, or we could try something else, exchange an intraocular lens for a suture posterior chamber intraocular lens. Finally it may be something like a painted contact lens would help her symptoms, because I believe what she is having is an edge affect in the intraocular lens, which is now visible around her iris.
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Cicatricial ROP with Macular Folds - 60 Year Old Woman Nystagmus795 views60-year-old was born at 6 pounds but then she was incubated and she had difficulty with her eye subsequent to that.
VISUAL ACUITY: OD 8/200, OS 1/200
(0 votes)
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Cicatricial ROP with Macular Folds - 60 Year Old Woman Nystagmus618 views60-year-old was born at 6 pounds but then she was incubated and she had difficulty with her eye subsequent to that.
VISUAL ACUITY: OD 8/200, OS 1/200
(0 votes)
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Cicatricial ROP with Macular Folds - 60 Year Old Woman Nystagmus591 views60-year-old was born at 6 pounds but then she was incubated and she had difficulty with her eye subsequent to that.
VISUAL ACUITY: OD 8/200, OS 1/200
(0 votes)
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Cicatricial ROP with Macular Folds - 60 Year Old Woman Nystagmus596 views60-year-old was born at 6 pounds but then she was incubated and she had difficulty with her eye subsequent to that.
VISUAL ACUITY: OD 8/200, OS 1/200
(0 votes)
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Cicatricial ROP with Macular Folds - 60 Year Old Woman Nystagmus641 views60-year-old was born at 6 pounds but then she was incubated and she had difficulty with her eye subsequent to that.
VISUAL ACUITY: OD 8/200, OS 1/200
(0 votes)
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Cicatricial ROP with Macular Folds - 60 Year Old Woman Nystagmus499 views60-year-old was born at 6 pounds but then she was incubated and she had difficulty with her eye subsequent to that.
VISUAL ACUITY: OD 8/200, OS 1/200
(0 votes)
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60-year-old woman was seen in the office on October 2, 2008. She was born with retinopathy prematurity. She was born at 6 pounds but then she was incubated and she had difficulty with her eye subsequent to that. She had cataract surgery done about 20 years ago. One surgery of the eye was done at West Florida, the other at St. Luke’s, and then she developed dislocation intraocular lens in the right eye. You removed the intraocular lens and put an anterior chamber intraocular lens in that eye in March of 2006. Subsequent to that she was doing very well with the right eye until about two or three months ago when she starting noticing halos and difficulty with her vision in that eye and shadows. You suggested she come in here for an evaluation for what to do about the right eye. She was worried the lens might have shifted.
VISUAL ACUITY: OD 8/200, OS 1/200. IOP: OD 14, OS 9.
SLIT LAMP EXAM: The right eye has an irregular iris. There is a superior iridectomy. The pupil is slightly ectopic. The anterior chamber intraocular lens does look dislocated slightly superiorly. The visual axis is still well within the optic but the haptics are slightly dislocated superiorly. The left eye has a posterior chamber intraocular lens which is mobile but still centered.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.0. There is a macular fold with extensive chorioretinal scarring throughout the retina.
OS: Vertical C/D ratio is 0.0. There is a macular fold and peripheral retinal folds. There is extensive chorioretinal scarring.
IMPRESSION:
1. NEW SYMPTOM OF HALOS AND VISION CHANGE – RIGHT EYE
2. SLIGHTLY DISLOCATED ANTERIOR CHAMBER INTRAOCULAR LENS – RIGHT EYE
3. MOBILE POSTERIOR CHAMBER INTRAOCULAR LENS – LEFT EYE
4. EXTENSIVE CHORIORETINAL SCARRING FOR RETINOPATHY PREMATURITY WITH RETINAL FOLDS IN THE MACULA – BOTH EYES
DISCUSSION: I explained to the patient the right intraocular lens has shifted slightly superiorly. However, the visual axis is still well within the optic and I suggested that she wait a month or two to see if the new symptoms might abate. Sometimes patients will adapt to changes in their vision and the symptoms have become less bothersome and even completely subside without any necessary surgery. I told her I could either reposition the anterior chamber intraocular lens in the eye, which may work but may not, or we could try something else, exchange an intraocular lens for a suture posterior chamber intraocular lens. Finally it may be something like a painted contact lens would help her symptoms, because I believe what she is having is an edge affect in the intraocular lens, which is now visible around her iris.
