Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargement
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33-year-old woman who I saw in the office on December 10, 2008. One week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. She had an MRI done in the emergency room, which was fine and comes in for an evaluation because of the vision change in the right eye.
VISUAL ACUITY: OD 20/20, OS 20/20. IOP: OD 11, OS 12.
SLIT EXAMINATION: The lens is clear in both eyes.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.0. There is 1+ vitreous cells. There are a few subtle white spots in the retina, predominately clustered around the nerve.
OS: Vertical C/D ration is 0.0. There is no posterior vitreous separation. Photos confirm clinical findings.
FLUORESCEIN ANGIOGRAM: The fluorescein angiogram shows a blush of fluorescein around the optic nerve in the right eye, which looks to be deep, without leakage. The optic nerve does not leak. There is no retinovasculitis. The left eye looked angiographically normal. I obtained a visual field test, which shows a normal visual field in both eyes.
IMPRESSION:
1. LOW-GRADE MULTIPLE EVANESCENT AND WHITE DOT SYNDROME – RIGHT EYE
DISCUSSION: I explained to the patient that findings are consistent with multiple evanescent and white dot syndrome. She looks to have a very mild case of it and I suspect this will reverse with time. I did ask her to return for a check in about six weeks or sooner should she notice a problem and see you regularly.
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvu 814 fois33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votes)
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvu 919 fois33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votes)
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvu 803 fois33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votes)
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvu 776 fois33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votes)
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvu 693 fois33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votes)
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvu 663 fois33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votes)
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvu 612 fois33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votes)
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvu 624 fois33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votes)
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvu 639 fois33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votes)
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvu 573 fois33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votes)
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvu 512 fois33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votes)
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvu 467 fois33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votes)
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvu 485 fois33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votes)
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvu 562 fois33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votes)
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvu 530 fois33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votes)
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvu 542 fois33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votes)
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvu 528 fois33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votes)
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvu 719 fois33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votes)
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvu 630 fois33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votes)
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvu 682 fois33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votes)
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33-year-old woman who I saw in the office on December 10, 2008. One week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. She had an MRI done in the emergency room, which was fine and comes in for an evaluation because of the vision change in the right eye.
VISUAL ACUITY: OD 20/20, OS 20/20. IOP: OD 11, OS 12.
SLIT EXAMINATION: The lens is clear in both eyes.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.0. There is 1+ vitreous cells. There are a few subtle white spots in the retina, predominately clustered around the nerve.
OS: Vertical C/D ration is 0.0. There is no posterior vitreous separation. Photos confirm clinical findings.
FLUORESCEIN ANGIOGRAM: The fluorescein angiogram shows a blush of fluorescein around the optic nerve in the right eye, which looks to be deep, without leakage. The optic nerve does not leak. There is no retinovasculitis. The left eye looked angiographically normal. I obtained a visual field test, which shows a normal visual field in both eyes.
IMPRESSION:
1. LOW-GRADE MULTIPLE EVANESCENT AND WHITE DOT SYNDROME – RIGHT EYE
DISCUSSION: I explained to the patient that findings are consistent with multiple evanescent and white dot syndrome. She looks to have a very mild case of it and I suspect this will reverse with time. I did ask her to return for a check in about six weeks or sooner should she notice a problem and see you regularly.
