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Top rated - Vitreomacular Traction

75-year-old woman was seen in the office on 2-7-08. She had decreasing vision in the right eye a few months ago. She had her cataract removed and unfortunately her vision is still hazy in the right eye. Her left eye seems a little hazy from the cataract. VISUAL ACUITY: OD 20/50, OS 20/20. IOP: OD 17, OS 18. SLIT-LAMP EXAMINATION: The right eye has a posterior chamber, intraocular lens in perfect position, left eye has 2+ nuclear sclerosis. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.1. There is a partial posterior vitreous separation and vitreomacular traction and underlying macular edema. OS: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. The macula and periphery look healthy. The OCT scan shows striking vitreomacular traction with a single strand still holding the posterior hyaloid to the fovea and the fovea being dragged anteriorly almost 1000 microns off of where it is suppose to be. The left eye was normal on OCT scan. IMPRESSION: 1. VITREOMACULAR TRACTION IN THE RIGHT EYE. 2. MACULAR EDEMA IN THE RIGHT EYE. 3. RECENT CATARACT SURGERY IN THE RIGHT EYE. DISCUSSION: I explained to the patient that she does have significant vitreomacular traction syndrome with tractional elevation of the fovea causing visual haze. Because there is already a partial posterior vitreous separation and because the vitreous hyaloid is so far elevated off of the fovea I think there is a reasonable chance this may spontaneously resolve. Because of that I asked her to return for a check in 6 to 8 weeks. I am hopeful the vitreous will pop free and the macula flatten out on its own. If not, then 2 years later - developed macular hole which aborted and then vision improved to 20/30

vmtract_OCT_OS_90DEG_10-7-08.jpg
Vitreomacular Traction - Closing Macular Hole - 20/40 Vision666 views75-year-old woman has a small macular hole in the right eye. It looked to be spontaneously closing, so I cancelled her surgery and I have been watching it. Her last visit was three months ago. She feels her vision is a little better and she is seeing some floaters.

VISUAL ACUITY: Vision OD is 20/40
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75-year-old woman was seen in the office on 2-7-08. She had decreasing vision in the right eye a few months ago. She had her cataract removed and unfortunately her vision is still hazy in the right eye. Her left eye seems a little hazy from the cataract. VISUAL ACUITY: OD 20/50, OS 20/20. IOP: OD 17, OS 18. SLIT-LAMP EXAMINATION: The right eye has a posterior chamber, intraocular lens in perfect position, left eye has 2+ nuclear sclerosis. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.1. There is a partial posterior vitreous separation and vitreomacular traction and underlying macular edema. OS: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. The macula and periphery look healthy. The OCT scan shows striking vitreomacular traction with a single strand still holding the posterior hyaloid to the fovea and the fovea being dragged anteriorly almost 1000 microns off of where it is suppose to be. The left eye was normal on OCT scan. IMPRESSION: 1. VITREOMACULAR TRACTION IN THE RIGHT EYE. 2. MACULAR EDEMA IN THE RIGHT EYE. 3. RECENT CATARACT SURGERY IN THE RIGHT EYE. DISCUSSION: I explained to the patient that she does have significant vitreomacular traction syndrome with tractional elevation of the fovea causing visual haze. Because there is already a partial posterior vitreous separation and because the vitreous hyaloid is so far elevated off of the fovea I think there is a reasonable chance this may spontaneously resolve. Because of that I asked her to return for a check in 6 to 8 weeks. I am hopeful the vitreous will pop free and the macula flatten out on its own. If not, then 2 years later - developed macular hole which aborted and then vision improved to 20/30