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48-year-old woman has had a change recently coming on over the last six to twelve months or so, where she has had a problem with light and dark adaptations. She notices when she sees a point source of light like a cell phone in a dimly lit room and then she turns the cell phone off, that subsequently her vision is very dark until she goes back into a well lighted area. She has not checked to see how long it takes her to re-dark if she stays in the dark. She is in good health, accept for having a severe food allergy, but she does eat a lot of vegetables and she does have a problem with migraines. VISUAL ACUITY: OD 20/20, OS 20/25. IOP: OD 14, OS 13. SLIT EXAMINATION: Normal with clear lenses. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.0. There is no posterior vitreous separation. The macula and periphery look healthy. OS: Vertical C/D ratio is 0.0. There is no posterior vitreous separation. The macula and periphery look healthy. FUNDUS AUTO FLUORESCENCE: The fundus auto fluorescence as well as spectral domain OCT scans of the macula are completely normal. IMPRESSION: 1. LIGHT AND DARK ADAPTATION ISSUE DISCUSSION: I explained to the patient there is a normal time where most people will take several minutes to darken once they are faced with a bright source of light and it sounds like she may be within normal range. I don’t think it is unreasonable to check a vitamin A level the next time she has her blood tests done, since she does have to modify her diet because of her food allergies. I suspect though it will be normal.

normalHeidelberg_nasc01.jpg
Normal Infrared Image338 views48-year-old woman has had a problem with light and dark adaptations. She notices when she sees a point source of light like a cell phone in a dimly lit room and then she turns the cell phone off, that subsequently her vision is very dark until she goes back into a well lighted area. OD 20/20, OS 20/25. 00000
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normalHeidelberg_nasc02.jpg
Normal Infrared Image213 views48-year-old woman has had a problem with light and dark adaptations. She notices when she sees a point source of light like a cell phone in a dimly lit room and then she turns the cell phone off, that subsequently her vision is very dark until she goes back into a well lighted area. OD 20/20, OS 20/25. 00000
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normalHeidelberg_nasc03.jpg
Normal Fundus Autofluorescence495 views48-year-old woman has had a problem with light and dark adaptations. She notices when she sees a point source of light like a cell phone in a dimly lit room and then she turns the cell phone off, that subsequently her vision is very dark until she goes back into a well lighted area. OD 20/20, OS 20/25. 00000
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normalHeidelberg_nasc04.jpg
Normal Fundus Autofluorescence406 views48-year-old woman has had a problem with light and dark adaptations. She notices when she sees a point source of light like a cell phone in a dimly lit room and then she turns the cell phone off, that subsequently her vision is very dark until she goes back into a well lighted area. OD 20/20, OS 20/25. 00000
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normalHeidelberg_nasc05.jpg
Normal Spectral Domain Optical Coherence Tomography (SD-OCT)368 views48-year-old woman has had a problem with light and dark adaptations. She notices when she sees a point source of light like a cell phone in a dimly lit room and then she turns the cell phone off, that subsequently her vision is very dark until she goes back into a well lighted area. OD 20/20, OS 20/25. 00000
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normalHeidelberg_nasc06.jpg
Normal Spectral Domain Optical Coherence Tomography (SD-OCT)500 views48-year-old woman has had a problem with light and dark adaptations. She notices when she sees a point source of light like a cell phone in a dimly lit room and then she turns the cell phone off, that subsequently her vision is very dark until she goes back into a well lighted area. OD 20/20, OS 20/25. 00000
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normalHeidelberg_nasc07.jpg
Normal Spectral Domain Optical Coherence Tomography (SD-OCT) - Prefoveal Vitreous Liquifaction633 views48-year-old woman has had a problem with light and dark adaptations. She notices when she sees a point source of light like a cell phone in a dimly lit room and then she turns the cell phone off, that subsequently her vision is very dark until she goes back into a well lighted area. OD 20/20, OS 20/25. 00000
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normalHeidelberg_nasc08.jpg
Normal Spectral Domain Optical Coherence Tomography (SD-OCT)583 views48-year-old woman has had a problem with light and dark adaptations. She notices when she sees a point source of light like a cell phone in a dimly lit room and then she turns the cell phone off, that subsequently her vision is very dark until she goes back into a well lighted area. OD 20/20, OS 20/25. 00000
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48-year-old woman has had a change recently coming on over the last six to twelve months or so, where she has had a problem with light and dark adaptations. She notices when she sees a point source of light like a cell phone in a dimly lit room and then she turns the cell phone off, that subsequently her vision is very dark until she goes back into a well lighted area. She has not checked to see how long it takes her to re-dark if she stays in the dark. She is in good health, accept for having a severe food allergy, but she does eat a lot of vegetables and she does have a problem with migraines. VISUAL ACUITY: OD 20/20, OS 20/25. IOP: OD 14, OS 13. SLIT EXAMINATION: Normal with clear lenses. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.0. There is no posterior vitreous separation. The macula and periphery look healthy. OS: Vertical C/D ratio is 0.0. There is no posterior vitreous separation. The macula and periphery look healthy. FUNDUS AUTO FLUORESCENCE: The fundus auto fluorescence as well as spectral domain OCT scans of the macula are completely normal. IMPRESSION: 1. LIGHT AND DARK ADAPTATION ISSUE DISCUSSION: I explained to the patient there is a normal time where most people will take several minutes to darken once they are faced with a bright source of light and it sounds like she may be within normal range. I don’t think it is unreasonable to check a vitamin A level the next time she has her blood tests done, since she does have to modify her diet because of her food allergies. I suspect though it will be normal.