Cotton Wool Spots after Severe Pneumonia
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60-year-old man was in the office on July 26, 2010. He was sick in the hospital in June with pneumonia. He had streptococcal pneumonia. He was in the cardiac intensive care unit and at one point he was in critical condition. He is better now and his vision didn’t bother him at anytime during the procedure. He was in for a comprehensive evaluation and you noticed cotton wool spots in the retina and suggest that he come here for an evaluation.
VISUAL ACUITY: OD 20/20, OS 20/25. IOP: OD 20, OS 16.
SLIT EXAMINATION: There is 1+ nuclear sclerosis in both eyes.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. There is a cotton wool spot superior to the macula and inferotemporal to the optic nerve.
OS: Vertical C/D ratio is 0.1. There are cotton wool spots superotemporal to the optic nerve. Photos confirm clinical findings.
IMPRESSION:
1. COTTON WOOL SPOTS – BOTH EYES
DISCUSSION: I explained to the patient given his recent critical illness, the cotton wool spots probably have something to do with complement activation issue he might have had at the time of the pneumonia and renal failure or possibly there was a problem with his perfusion. Either way I don’t see anything sinister in the eye,
but I told him he does need to return for one more check in about two months to make sure that they are appropriately resolved.
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Cotton Wool Spots now Gone in Both Eyes531 views60-year-old man was sick in the hospital in 3 month ago with streptococcal pneumonia. He was in the cardiac intensive care unit and at one point he was in critical condition. He has no visual complaints. OD 20/20, OS 20/25. Cotton Wool Spots now GONE
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Cotton Wool Spots now Gone in Both Eyes447 views60-year-old man was sick in the hospital in 3 month ago with streptococcal pneumonia. He was in the cardiac intensive care unit and at one point he was in critical condition. He has no visual complaints. OD 20/20, OS 20/25. Cotton Wool Spots now GONE
(0 votes)
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Cotton Wool Spots now Gone in Both Eyes436 views60-year-old man was sick in the hospital in 3 month ago with streptococcal pneumonia. He was in the cardiac intensive care unit and at one point he was in critical condition. He has no visual complaints. OD 20/20, OS 20/25. Cotton Wool Spots now GONE
(0 votes)
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Cotton Wool Spots now Gone in Both Eyes531 views60-year-old man was sick in the hospital in 3 month ago with streptococcal pneumonia. He was in the cardiac intensive care unit and at one point he was in critical condition. He has no visual complaints. OD 20/20, OS 20/25. Cotton Wool Spots now GONE
(0 votes)
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Cotton Wool Spots now Gone in Both Eyes477 views60-year-old man was sick in the hospital in 3 month ago with streptococcal pneumonia. He was in the cardiac intensive care unit and at one point he was in critical condition. He has no visual complaints. OD 20/20, OS 20/25. Cotton Wool Spots now GONE
(0 votes)
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Cotton Wool Spots now Gone in Both Eyes419 views60-year-old man was sick in the hospital in 3 month ago with streptococcal pneumonia. He was in the cardiac intensive care unit and at one point he was in critical condition. He has no visual complaints. OD 20/20, OS 20/25. Cotton Wool Spots now GONE
(0 votes)
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Cotton Wool Spots Both Eyes after Strep Pneumonia and Cardiac ICU Stay 1 Month Ago 416 views60-year-old man was sick in the hospital in 1 month ago with streptococcal pneumonia. He was in the cardiac intensive care unit and at one point he was in critical condition. He has no visual complaints. OD 20/20, OS 20/25.
(0 votes)
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Cotton Wool Spots Both Eyes after Strep Pneumonia and Cardiac ICU Stay 1 Month Ago 423 views60-year-old man was sick in the hospital in 1 month ago with streptococcal pneumonia. He was in the cardiac intensive care unit and at one point he was in critical condition. He has no visual complaints. OD 20/20, OS 20/25.
(0 votes)
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Cotton Wool Spots Both Eyes after Strep Pneumonia and Cardiac ICU Stay 1 Month Ago 461 views60-year-old man was sick in the hospital in 1 month ago with streptococcal pneumonia. He was in the cardiac intensive care unit and at one point he was in critical condition. He has no visual complaints. OD 20/20, OS 20/25.
(0 votes)
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Cotton Wool Spots Both Eyes after Strep Pneumonia and Cardiac ICU Stay 1 Month Ago 495 views60-year-old man was sick in the hospital in 1 month ago with streptococcal pneumonia. He was in the cardiac intensive care unit and at one point he was in critical condition. He has no visual complaints. OD 20/20, OS 20/25.
(0 votes)
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Cotton Wool Spots Both Eyes after Strep Pneumonia and Cardiac ICU Stay 1 Month Ago 492 views60-year-old man was sick in the hospital in 1 month ago with streptococcal pneumonia. He was in the cardiac intensive care unit and at one point he was in critical condition. He has no visual complaints. OD 20/20, OS 20/25.
(0 votes)
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Cotton Wool Spots Both Eyes after Strep Pneumonia and Cardiac ICU Stay 1 Month Ago 587 views60-year-old man was sick in the hospital in 1 month ago with streptococcal pneumonia. He was in the cardiac intensive care unit and at one point he was in critical condition. He has no visual complaints. OD 20/20, OS 20/25.
(0 votes)
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60-year-old man was in the office on July 26, 2010. He was sick in the hospital in June with pneumonia. He had streptococcal pneumonia. He was in the cardiac intensive care unit and at one point he was in critical condition. He is better now and his vision didn’t bother him at anytime during the procedure. He was in for a comprehensive evaluation and you noticed cotton wool spots in the retina and suggest that he come here for an evaluation.
VISUAL ACUITY: OD 20/20, OS 20/25. IOP: OD 20, OS 16.
SLIT EXAMINATION: There is 1+ nuclear sclerosis in both eyes.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. There is a cotton wool spot superior to the macula and inferotemporal to the optic nerve.
OS: Vertical C/D ratio is 0.1. There are cotton wool spots superotemporal to the optic nerve. Photos confirm clinical findings.
IMPRESSION:
1. COTTON WOOL SPOTS – BOTH EYES
DISCUSSION: I explained to the patient given his recent critical illness, the cotton wool spots probably have something to do with complement activation issue he might have had at the time of the pneumonia and renal failure or possibly there was a problem with his perfusion. Either way I don’t see anything sinister in the eye,
but I told him he does need to return for one more check in about two months to make sure that they are appropriately resolved.
