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 830 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 943 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 819 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 785 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 702 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 670 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 622 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 635 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 655 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 594 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 523 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 477 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 493 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 571 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 545 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 565 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 546 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 724 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 642 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 690 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.
