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This pleasant 59-year-old man was seen in the office on 7/9/2010. He had new onset floaters about a year ago. Subsequent to that his vision was not quite right in the right eye and then he noticed, starting about three weeks ago, substantial change in the vision. In the morning he sees what he calls a small gray circle with a ring of fire around it and then subsequent to that the vision becomes more normal but not quite right. His vision in the left eye is fine. I appreciate the photos from your office which showed a macular pucker in the right eye and your notes documenting the vision change. VISUAL ACUITY: Vision OD is 20/50, OS is 20/16. IOP: OD 20, OS not dilated. The right eye has 2+ nuclear sclerosis. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.3. There is a posterior vitreous separation and 2+ epiretinal membrane. OCT SCAN: The OCT scan shows a macular pucker with an average central foveal thickness of 482 microns. The photoreceptors are slightly disrupted, but there is no subretinal fluid. PHOTOGRAPHS: Photos confirm clinical findings. FLUORESCEIN ANGIOGRAPHY: FA shows excellent circulation with only minimal leakage consistent with a macular pucker. IMPRESSION: 1. MACULAR PUCKER – RIGHT EYE 2. VITREOUS SEPARATION – RIGHT EYE DISCUSSION: I explained to the patient he does have visually significant macular pucker in the right eye. With surgery there is an 80% chance of substantially improving his vision with relatively low risk. I have suggested he consider that within the next three to six months. There is no emergency to the surgery, but I would probably recommend he do it sooner than later. I asked him to see you back regularly. I warned him about the side effects of the surgery. He does obtain some care through the Veteran’s Administration and I do not think it would be unreasonable for him to consider having the surgery done there. Thank you for allowing me to participate in his care.

puckerpreop.jpg
Macular Pucker186 viewsThis pleasant 59-year-old man was seen in the office on 7/9/2010. He had new onset floaters about a year ago. Subsequent to that his vision was not quite right in the right eye and then he noticed, starting about three weeks ago, substantial change in the vision. In the morning he sees what he calls a small gray circle with a ring of fire around it and then subsequent to that the vision becomes more normal but not quite right. His vision in the left eye is fine. Vision OD is 20/50, OS is 20/16. 00000
(0 votes)
puckerposopoct.jpg
Macular Pucker149 views. This pleasant 59-year-old man had vitrectomy for a macular pucker in the right eye in July. His vision is gradually improving.

VISUAL ACUITY: Vision OD is 20/30. IOP: OD 22. There is 2+ nuclear sclerosis.

EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.5. The macula is smooth and the retina is attached.

OCT SCAN: The OCT scan shows an average central foveal thickness of 349 microns, which compares favorably to the pre-op thickness of 482 microns.
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(0 votes)
puckerpostop.jpg
Macular Pucker119 views. This pleasant 59-year-old man had vitrectomy for a macular pucker in the right eye in July. His vision is gradually improving.

VISUAL ACUITY: Vision OD is 20/30. IOP: OD 22. There is 2+ nuclear sclerosis.

EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.5. The macula is smooth and the retina is attached.

OCT SCAN: The OCT scan shows an average central foveal thickness of 349 microns, which compares favorably to the pre-op thickness of 482 microns.

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(0 votes)
puckerpreiopoct.jpg
Macular Pucker112 viewsThis pleasant 59-year-old man was seen in the office on 7/9/2010. He had new onset floaters about a year ago. Subsequent to that his vision was not quite right in the right eye and then he noticed, starting about three weeks ago, substantial change in the vision. In the morning he sees what he calls a small gray circle with a ring of fire around it and then subsequent to that the vision becomes more normal but not quite right. His vision in the left eye is fine. Vision OD is 20/50, OS is 20/16. 00000
(0 votes)
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This pleasant 59-year-old man was seen in the office on 7/9/2010. He had new onset floaters about a year ago. Subsequent to that his vision was not quite right in the right eye and then he noticed, starting about three weeks ago, substantial change in the vision. In the morning he sees what he calls a small gray circle with a ring of fire around it and then subsequent to that the vision becomes more normal but not quite right. His vision in the left eye is fine. I appreciate the photos from your office which showed a macular pucker in the right eye and your notes documenting the vision change. VISUAL ACUITY: Vision OD is 20/50, OS is 20/16. IOP: OD 20, OS not dilated. The right eye has 2+ nuclear sclerosis. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.3. There is a posterior vitreous separation and 2+ epiretinal membrane. OCT SCAN: The OCT scan shows a macular pucker with an average central foveal thickness of 482 microns. The photoreceptors are slightly disrupted, but there is no subretinal fluid. PHOTOGRAPHS: Photos confirm clinical findings. FLUORESCEIN ANGIOGRAPHY: FA shows excellent circulation with only minimal leakage consistent with a macular pucker. IMPRESSION: 1. MACULAR PUCKER – RIGHT EYE 2. VITREOUS SEPARATION – RIGHT EYE DISCUSSION: I explained to the patient he does have visually significant macular pucker in the right eye. With surgery there is an 80% chance of substantially improving his vision with relatively low risk. I have suggested he consider that within the next three to six months. There is no emergency to the surgery, but I would probably recommend he do it sooner than later. I asked him to see you back regularly. I warned him about the side effects of the surgery. He does obtain some care through the Veteran’s Administration and I do not think it would be unreasonable for him to consider having the surgery done there. Thank you for allowing me to participate in his care.