Asymptomatic Peripheral Retinal Detachment - Optical Coherence Tomography - Laser Demarcation - 24 Year Old
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24-year-old was seen in the office on 8/21/2012. He had photorefractive keratotomy in both eyes in January of 2012. He also had an episode about three weeks ago where he was in the engine room. He was a little overheated and he had a funny sort of visual phenomena where he saw light temporally, which was unusual and sort of watery looking, for about a half hour. He had a little bit of a headache. He did have a similar episode some time ago. He had an eye exam with you recently. You saw a problem with the peripheral retina and suggested he come here for an evaluation. He also did have some laser done by you at one of those visits.
VISUAL ACUITY: His vision is 20/20 in each eye. IOP: 17 in both eyes.
SLIT LAMP EXAM: Normal with clear lenses.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.2. There is a demarcated clinical retinal detachment superotemporally straddling the equator, extending about 3-disc diameters posterior to the equator with a light white demarcation line around it. It is circular. With scleral depression, there are no other tears or detachments.
OS: Vertical C/D ratio is 0.2. With scleral depression, the macula and periphery look healthy. Because it was a little atypical looking, I did an OCT scan.
OCT SCAN: The OCT scan clearly does show it is a retinal detachment.
PHOTOGRAPHS: Photos show the demarcation line nicely.
IMPRESSION:
1. CLINICAL ASYMPTOMATIC PERIPHERAL RETINAL DETACHMENT – RIGHT EYE
DISCUSSION: I explained to the patient with asymptomatic retinal detachments, I sometimes do leave the eyes alone; however, since this is superior, there is a little higher risk of it causing trouble. Also, because he is military and will probably be going into aviation, the activity level he experiences is more than average and the risk of this progressing to a retinal detachment is probably higher than the average person. The risk of a detachment like this progressing is probably around 1 or 2%, but his is probably higher but probably no more than 10%. I talked with him about this. The risk of laser is probably less than 1:200, and I suggested we go ahead with laser demarcation. He tolerated that fine. I put three to five rows of laser all the way around the detachment. I asked him to return for check in two weeks, sooner should he notice a problem.
I asked him to restrict activity until then. Tomorrow he has planned shooting and pepper spray activity which I told him, because of the eye problem today, he needs to postpone for at least a little while.
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Asymptomatic Retinal Detachment Confirmed with Optical Coherence Tomography (OCT)856 views24-year-old 20/20 vision in each eye. Patient referred for retinoschisis. OCT confirmed retinal detachment. Patient is very active and in military so the detachment was treated with laser demarcation.
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Asymptomatic Retinal Detachment Confirmed with Optical Coherence Tomography (OCT)752 views24-year-old 20/20 vision in each eye. Patient referred for retinoschisis. OCT confirmed retinal detachment. Patient is very active and in military so the detachment was treated with laser demarcation.
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Asymptomatic Retinal Detachment Confirmed with Optical Coherence Tomography (OCT)757 views24-year-old 20/20 vision in each eye. Patient referred for retinoschisis. OCT confirmed retinal detachment. Patient is very active and in military so the detachment was treated with laser demarcation.
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Asymptomatic Retinal Detachment Confirmed with Optical Coherence Tomography (OCT)767 views24-year-old 20/20 vision in each eye. Patient referred for retinoschisis. OCT confirmed retinal detachment. Patient is very active and in military so the detachment was treated with laser demarcation.
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Asymptomatic Retinal Detachment Confirmed with Optical Coherence Tomography (OCT)734 views24-year-old 20/20 vision in each eye. Patient referred for retinoschisis. OCT confirmed retinal detachment. Patient is very active and in military so the detachment was treated with laser.
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Asymptomatic Laser Demarcated Retinal Detachment has Spontaneously Re-attached 6 Months After Laser717 viewsSpontaneously Re-attached Detached Retina
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24-year-old was seen in the office on 8/21/2012. He had photorefractive keratotomy in both eyes in January of 2012. He also had an episode about three weeks ago where he was in the engine room. He was a little overheated and he had a funny sort of visual phenomena where he saw light temporally, which was unusual and sort of watery looking, for about a half hour. He had a little bit of a headache. He did have a similar episode some time ago. He had an eye exam with you recently. You saw a problem with the peripheral retina and suggested he come here for an evaluation. He also did have some laser done by you at one of those visits.
VISUAL ACUITY: His vision is 20/20 in each eye. IOP: 17 in both eyes.
SLIT LAMP EXAM: Normal with clear lenses.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.2. There is a demarcated clinical retinal detachment superotemporally straddling the equator, extending about 3-disc diameters posterior to the equator with a light white demarcation line around it. It is circular. With scleral depression, there are no other tears or detachments.
OS: Vertical C/D ratio is 0.2. With scleral depression, the macula and periphery look healthy. Because it was a little atypical looking, I did an OCT scan.
OCT SCAN: The OCT scan clearly does show it is a retinal detachment.
PHOTOGRAPHS: Photos show the demarcation line nicely.
IMPRESSION:
1. CLINICAL ASYMPTOMATIC PERIPHERAL RETINAL DETACHMENT – RIGHT EYE
DISCUSSION: I explained to the patient with asymptomatic retinal detachments, I sometimes do leave the eyes alone; however, since this is superior, there is a little higher risk of it causing trouble. Also, because he is military and will probably be going into aviation, the activity level he experiences is more than average and the risk of this progressing to a retinal detachment is probably higher than the average person. The risk of a detachment like this progressing is probably around 1 or 2%, but his is probably higher but probably no more than 10%. I talked with him about this. The risk of laser is probably less than 1:200, and I suggested we go ahead with laser demarcation. He tolerated that fine. I put three to five rows of laser all the way around the detachment. I asked him to return for check in two weeks, sooner should he notice a problem.
I asked him to restrict activity until then. Tomorrow he has planned shooting and pepper spray activity which I told him, because of the eye problem today, he needs to postpone for at least a little while.
