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83-year-old woman was seen in the office on 6/29/2010. She had cataract surgery done May 26th. Since then the vision in the right eye seems to be, if anything, worse than it was prior to the surgery. She has difficulty seeing straight ahead. She noticed before when she looked on the grid, there was a dark spot centrally, but then around the edge of the dark spot, things looked good. Now she notices everything is blurred in the right eye. The vision in the left eye is stable. She does have a cataract still in the left eye. VISUAL ACUITY: Vision OD is 10/200, OS is 20/50. IOP: OD 13, OS 11. The right eye has a posterior chamber intraocular lens in good position. The left eye has 1+ nuclear sclerosis. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.1. There is concentric geographic atrophy in the macula. There are 2+ drusen. There is also a fibrotic scar around the optic nerve and inferior to it. OS: Vertical C/D ratio is 0.1. There is geographic atrophy centrally. OCT SCAN: There is foveal atrophy unchanged from previous scans. PHOTOGRAPHS: Photos confirm clinical findings. FLUORESCEIN ANGIOGRAPHY: The FA shows a well-circumscribed area of geographic atrophy in the macula of each eye with no evidence of any leakage on the angiogram. In the late views there is staining of the scar in the right eye adjacent to the optic nerve. IMPRESSION: 1. VISION LOSS AFTER CATARACT SURGERY – RIGHT EYE 2. GEOGRAPHIC ATROPHY – BOTH EYES 3. JUXTAPAPILLARY CHORIORETINAL SCAR – RIGHT EYE 4. POSTERIOR CAPSULAR OPACITY – RIGHT EYE DISCUSSION: I explained to the patient that although there is a posterior capsular opacity in the right eye, I think some of the vision loss may have to do with her macular degeneration. There are occasional people with dry age-related macular degeneration who have vision loss after cataract surgery and often that recovers within a few months. Addendum: Vision never recovered with 1 year followup VA was 5/200 right eye.

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Scar - Juxtapapillary and Foveal Geographic Atrophy - Wet Macular Degeneration193 views83-year-old woman vision loss after cataract surgery right eye one month ago. The vision in the left eye is stable. She does have a cataract still in the left eye.

VISUAL ACUITY: Vision OD is 10/200, OS is 20/50.
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Scar - Juxtapapillary and Foveal Geographic Atrophy - Wet Macular Degeneration81 views83-year-old woman vision loss after cataract surgery right eye one month ago. The vision in the left eye is stable. She does have a cataract still in the left eye.

VISUAL ACUITY: Vision OD is 10/200, OS is 20/50.
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Scar - Juxtapapillary and Foveal Geographic Atrophy - Wet Macular Degeneration72 views83-year-old woman vision loss after cataract surgery right eye one month ago. The vision in the left eye is stable. She does have a cataract still in the left eye.

VISUAL ACUITY: Vision OD is 10/200, OS is 20/50.
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Scar - Juxtapapillary and Foveal Geographic Atrophy - Wet Macular Degeneration100 views83-year-old woman vision loss after cataract surgery right eye one month ago. The vision in the left eye is stable. She does have a cataract still in the left eye.

VISUAL ACUITY: Vision OD is 10/200, OS is 20/50.
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Scar - Juxtapapillary and Foveal Geographic Atrophy - Wet Macular Degeneration155 views83-year-old woman vision loss after cataract surgery right eye one month ago. The vision in the left eye is stable. She does have a cataract still in the left eye.

VISUAL ACUITY: Vision OD is 10/200, OS is 20/50.
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Scar - Juxtapapillary and Foveal Geographic Atrophy - Wet Macular Degeneration89 views83-year-old woman vision loss after cataract surgery right eye one month ago. The vision in the left eye is stable. She does have a cataract still in the left eye.

VISUAL ACUITY: Vision OD is 10/200, OS is 20/50.
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Scar - Juxtapapillary and Foveal Geographic Atrophy - Wet Macular Degeneration68 views83-year-old woman vision loss after cataract surgery right eye one month ago. The vision in the left eye is stable. She does have a cataract still in the left eye.

VISUAL ACUITY: Vision OD is 10/200, OS is 20/50.
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Scar - Juxtapapillary and Foveal Geographic Atrophy - Wet Macular Degeneration53 views83-year-old woman vision loss after cataract surgery right eye one month ago. The vision in the left eye is stable. She does have a cataract still in the left eye.

VISUAL ACUITY: Vision OD is 10/200, OS is 20/50.
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Scar - Juxtapapillary and Foveal Geographic Atrophy - Wet Macular Degeneration55 views83-year-old woman vision loss after cataract surgery right eye one month ago. The vision in the left eye is stable. She does have a cataract still in the left eye.

VISUAL ACUITY: Vision OD is 10/200, OS is 20/50.
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Scar - Juxtapapillary and Foveal Geographic Atrophy - Wet Macular Degeneration102 views83-year-old woman vision loss after cataract surgery right eye one month ago. The vision in the left eye is stable. She does have a cataract still in the left eye.

VISUAL ACUITY: Vision OD is 10/200, OS is 20/50.
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Scar - Juxtapapillary and Foveal Geographic Atrophy - Wet Macular Degeneration67 views83-year-old woman vision loss after cataract surgery right eye one month ago. The vision in the left eye is stable. She does have a cataract still in the left eye.

VISUAL ACUITY: Vision OD is 10/200, OS is 20/50.
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Scar - Juxtapapillary and Foveal Geographic Atrophy - Wet Macular Degeneration56 views83-year-old woman vision loss after cataract surgery right eye one month ago. The vision in the left eye is stable. She does have a cataract still in the left eye.

VISUAL ACUITY: Vision OD is 10/200, OS is 20/50.
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Scar - Juxtapapillary and Foveal Geographic Atrophy - Wet Macular Degeneration71 views83-year-old woman vision loss after cataract surgery right eye one month ago. The vision in the left eye is stable. She does have a cataract still in the left eye.

VISUAL ACUITY: Vision OD is 10/200, OS is 20/50.
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Scar - Juxtapapillary and Foveal Geographic Atrophy - Wet Macular Degeneration61 views83-year-old woman vision loss after cataract surgery right eye one month ago. The vision in the left eye is stable. She does have a cataract still in the left eye.

VISUAL ACUITY: Vision OD is 10/200, OS is 20/50.
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Scar - Juxtapapillary and Foveal Geographic Atrophy - Wet Macular Degeneration67 views83-year-old woman vision loss after cataract surgery right eye one month ago. The vision in the left eye is stable. She does have a cataract still in the left eye.

VISUAL ACUITY: Vision OD is 10/200, OS is 20/50.
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jpscargatro_roal16.jpg
Scar - Juxtapapillary and Foveal Geographic Atrophy - Wet Macular Degeneration84 views83-year-old woman vision loss after cataract surgery right eye one month ago. The vision in the left eye is stable. She does have a cataract still in the left eye.

VISUAL ACUITY: Vision OD is 10/200, OS is 20/50.
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Scar - Juxtapapillary and Foveal Geographic Atrophy - Wet Macular Degeneration86 views83-year-old woman vision loss after cataract surgery right eye one month ago. The vision in the left eye is stable. She does have a cataract still in the left eye.

VISUAL ACUITY: Vision OD is 10/200, OS is 20/50.
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Scar - Juxtapapillary and Foveal Geographic Atrophy - Wet Macular Degeneration113 views83-year-old woman vision loss after cataract surgery right eye one month ago. The vision in the left eye is stable. She does have a cataract still in the left eye.

VISUAL ACUITY: Vision OD is 10/200, OS is 20/50.
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Scar - Juxtapapillary and Foveal Geographic Atrophy - Wet Macular Degeneration121 views83-year-old woman vision loss after cataract surgery right eye one month ago. The vision in the left eye is stable. She does have a cataract still in the left eye.

VISUAL ACUITY: Vision OD is 10/200, OS is 20/50.
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Scar - Juxtapapillary and Foveal Geographic Atrophy - Wet Macular Degeneration155 views83-year-old woman vision loss after cataract surgery right eye one month ago. The vision in the left eye is stable. She does have a cataract still in the left eye.

VISUAL ACUITY: Vision OD is 10/200, OS is 20/50.
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83-year-old woman was seen in the office on 6/29/2010. She had cataract surgery done May 26th. Since then the vision in the right eye seems to be, if anything, worse than it was prior to the surgery. She has difficulty seeing straight ahead. She noticed before when she looked on the grid, there was a dark spot centrally, but then around the edge of the dark spot, things looked good. Now she notices everything is blurred in the right eye. The vision in the left eye is stable. She does have a cataract still in the left eye. VISUAL ACUITY: Vision OD is 10/200, OS is 20/50. IOP: OD 13, OS 11. The right eye has a posterior chamber intraocular lens in good position. The left eye has 1+ nuclear sclerosis. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.1. There is concentric geographic atrophy in the macula. There are 2+ drusen. There is also a fibrotic scar around the optic nerve and inferior to it. OS: Vertical C/D ratio is 0.1. There is geographic atrophy centrally. OCT SCAN: There is foveal atrophy unchanged from previous scans. PHOTOGRAPHS: Photos confirm clinical findings. FLUORESCEIN ANGIOGRAPHY: The FA shows a well-circumscribed area of geographic atrophy in the macula of each eye with no evidence of any leakage on the angiogram. In the late views there is staining of the scar in the right eye adjacent to the optic nerve. IMPRESSION: 1. VISION LOSS AFTER CATARACT SURGERY – RIGHT EYE 2. GEOGRAPHIC ATROPHY – BOTH EYES 3. JUXTAPAPILLARY CHORIORETINAL SCAR – RIGHT EYE 4. POSTERIOR CAPSULAR OPACITY – RIGHT EYE DISCUSSION: I explained to the patient that although there is a posterior capsular opacity in the right eye, I think some of the vision loss may have to do with her macular degeneration. There are occasional people with dry age-related macular degeneration who have vision loss after cataract surgery and often that recovers within a few months. Addendum: Vision never recovered with 1 year followup VA was 5/200 right eye.