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73-year-old woman who noticed two days ago she was bending over and had a sudden “ribbon” in her vision which looked to her like blood. It has since cleared some, but you noticed a problem with the macula and suggested she come here for evaluation. I appreciate your note which was helpful. She does take Avastin and chemotherapy. She runs a little bit anemic from that. She is not on any blood thinners. VISUAL ACUITY: Vision OD is 20/25, OS is 20/20. IOP: OD 12, OS 10. SLIT LAMP EXAM: The posterior chamber intraocular lens is in good position in both eyes. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.2. There is a posterior vitreous separation and 1+ vitreous hemorrhage. There is a retinal tear superotemporally with a subclinical retinal detachment around it. There is a 1+ vitreous hemorrhage. OS: Vertical C/D ratio is 0.2. There is no posterior vitreous separation. The macula and periphery look healthy. IMPRESSION: 1. RETINAL TEAR – RIGHT EYE 2. SUBCLINICAL RETINAL DETACHMENT – RIGHT EYE 3. VITREOUS HEMORRHAGE – RIGHT EYE DISCUSSION: I explained to the patient there is a retinal tear with a small retinal detachment around it. If left alone, there is about an 80% chance that will proceed to a clinical retinal detachment. With laser, we can reduce the risk of progression of that tear down to 1%. The office visit included a 15-minute counseling session during which I reviewed the alternatives, risks, benefits and limitations of various treatment options. I treated the retinal detachment with laser without any difficulty. I asked her to return for check in one to two weeks. In the meantime, she will avoid jarring activity, blood thinners, and heavy lifting. I asked her to return urgently should she notice a problem. I warned her there is a 10% chance of subsequent retinal tears in the same eye and for that reason she needs to be watched periodically. She will return urgently should she have a problem. She understands the laser will not help the floaters but those should settle within the next few weeks or months.

tearcrt_algr01.jpg
Retinal Flap Tear - Horseshoe - Cystic Retinal Tuft on Flap524 views73-year-old woman who noticed two days ago she was bending over and had a sudden “ribbon” in her
vision which looked to her like blood. VISUAL ACUITY: Vision OD is 20/25, OS is 20/20.
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tearcrt_algr02.jpg
Retinal Flap Tear - Horseshoe - Cystic Retinal Tuft on Flap352 views73-year-old woman who noticed two days ago she was bending over and had a sudden “ribbon” in her
vision which looked to her like blood. VISUAL ACUITY: Vision OD is 20/25, OS is 20/20.
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tearcrt_algr03.jpg
Retinal Flap Tear - Horseshoe - Cystic Retinal Tuft on Flap510 views73-year-old woman who noticed two days ago she was bending over and had a sudden “ribbon” in her
vision which looked to her like blood. VISUAL ACUITY: Vision OD is 20/25, OS is 20/20.
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tearcrt_algr04.jpg
Retinal Flap Tear - Horseshoe - Cystic Retinal Tuft on Flap351 views73-year-old woman who noticed two days ago she was bending over and had a sudden “ribbon” in her
vision which looked to her like blood. VISUAL ACUITY: Vision OD is 20/25, OS is 20/20.
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tearcrt_algr05.jpg
Retinal Flap Tear - Horseshoe - Cystic Retinal Tuft on Flap997 views73-year-old woman who noticed two days ago she was bending over and had a sudden “ribbon” in her
vision which looked to her like blood. VISUAL ACUITY: Vision OD is 20/25, OS is 20/20.
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tearcrt_algr06.jpg
Retinal Flap Tear - Horseshoe - Cystic Retinal Tuft on Flap310 views73-year-old woman who noticed two days ago she was bending over and had a sudden “ribbon” in her
vision which looked to her like blood. VISUAL ACUITY: Vision OD is 20/25, OS is 20/20.
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73-year-old woman who noticed two days ago she was bending over and had a sudden “ribbon” in her vision which looked to her like blood. It has since cleared some, but you noticed a problem with the macula and suggested she come here for evaluation. I appreciate your note which was helpful. She does take Avastin and chemotherapy. She runs a little bit anemic from that. She is not on any blood thinners. VISUAL ACUITY: Vision OD is 20/25, OS is 20/20. IOP: OD 12, OS 10. SLIT LAMP EXAM: The posterior chamber intraocular lens is in good position in both eyes. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.2. There is a posterior vitreous separation and 1+ vitreous hemorrhage. There is a retinal tear superotemporally with a subclinical retinal detachment around it. There is a 1+ vitreous hemorrhage. OS: Vertical C/D ratio is 0.2. There is no posterior vitreous separation. The macula and periphery look healthy. IMPRESSION: 1. RETINAL TEAR – RIGHT EYE 2. SUBCLINICAL RETINAL DETACHMENT – RIGHT EYE 3. VITREOUS HEMORRHAGE – RIGHT EYE DISCUSSION: I explained to the patient there is a retinal tear with a small retinal detachment around it. If left alone, there is about an 80% chance that will proceed to a clinical retinal detachment. With laser, we can reduce the risk of progression of that tear down to 1%. The office visit included a 15-minute counseling session during which I reviewed the alternatives, risks, benefits and limitations of various treatment options. I treated the retinal detachment with laser without any difficulty. I asked her to return for check in one to two weeks. In the meantime, she will avoid jarring activity, blood thinners, and heavy lifting. I asked her to return urgently should she notice a problem. I warned her there is a 10% chance of subsequent retinal tears in the same eye and for that reason she needs to be watched periodically. She will return urgently should she have a problem. She understands the laser will not help the floaters but those should settle within the next few weeks or months.