Gas Bubble on Optic Nerve after Pneumatic Retinopexy
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80-year-old man was seen in the office on 9-27-11. He had cataract surgery done in the right eye 5-years-ago. He noticed just last night his vision began to decline in the right eye. You saw a retinal detachment and suggested he come here for an evaluation. He has had a heart stent. He takes aspirin.
VISUAL ACUITY: OD 3/200, OS 20/40. IOP: OD 12, OS 18.
SLIT-LAMP EXAMINATION: The right eye has a posterior chamber, intraocular lens in good position, left eye 3+ nuclear sclerosis.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.1. There is a superotemporal retinal detachment extending from 8:00 around to 1:00. The macula is detached. It is a bullous retinal detachment and there are also 3 tiny retinal holes superotemporally.
OS: Vertical C/D ratio is 0.1. There is a posterior vitreous separation with scleral depression, no retinal tears.
IMPRESSION:
1. MACULA-OFF RETINAL DETACHMENT IN THE RIGHT EYE.
2. RETINAL HOLES IN THE RIGHT EYE.
3. VITREOUS SEPARATION IN BOTH EYES.
DISCUSSION: I explained to the patient that with pneumatic retinopexy there is about an 80 to 90% chance of reattaching the retina in that eye. I treated him with cryo therapy on the retinal breaks, injected the eye with 0.3 cc C3F8 bubble. I asked him to position upright during the day tilted a little bit sleeping on his left side at night and also he will need to do face down positioning. 10-15 minutes every hour or 2 for the next 2 days to avoid a macular fold. He will return for a check tomorrow, sooner should he notice a problem and see you regularly. Thank you for allowing me to participate in his care.
FU - VA was 20/40 3 months after procedure. The included photos are from 2 weeks after the procedure.
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Post-Pneumatic Retinopexy Gas Bubble on Optic Nerve717 views80 year old man, 2 weeks post C3F8 pneumatic retinopexy for 5/200 macula-off retinal detachment. Vision is 20/50 (final vision was about 20/30). There is a gas bubble trapped in the optic nerve.
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Post-Pneumatic Retinopexy Gas Bubble on Optic Nerve617 views80 year old man, 2 weeks post C3F8 pneumatic retinopexy for 5/200 macula-off retinal detachment. Vision is 20/50 (final vision was about 20/30). There is a gas bubble trapped in the optic nerve.
(0 votes)
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Post-Pneumatic Retinopexy Gas Bubble on Optic Nerve650 views80 year old man, 2 weeks post C3F8 pneumatic retinopexy for 5/200 macula-off retinal detachment. Vision is 20/50 (final vision was about 20/30). There is a gas bubble trapped in the optic nerve.
(0 votes)
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80-year-old man was seen in the office on 9-27-11. He had cataract surgery done in the right eye 5-years-ago. He noticed just last night his vision began to decline in the right eye. You saw a retinal detachment and suggested he come here for an evaluation. He has had a heart stent. He takes aspirin.
VISUAL ACUITY: OD 3/200, OS 20/40. IOP: OD 12, OS 18.
SLIT-LAMP EXAMINATION: The right eye has a posterior chamber, intraocular lens in good position, left eye 3+ nuclear sclerosis.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.1. There is a superotemporal retinal detachment extending from 8:00 around to 1:00. The macula is detached. It is a bullous retinal detachment and there are also 3 tiny retinal holes superotemporally.
OS: Vertical C/D ratio is 0.1. There is a posterior vitreous separation with scleral depression, no retinal tears.
IMPRESSION:
1. MACULA-OFF RETINAL DETACHMENT IN THE RIGHT EYE.
2. RETINAL HOLES IN THE RIGHT EYE.
3. VITREOUS SEPARATION IN BOTH EYES.
DISCUSSION: I explained to the patient that with pneumatic retinopexy there is about an 80 to 90% chance of reattaching the retina in that eye. I treated him with cryo therapy on the retinal breaks, injected the eye with 0.3 cc C3F8 bubble. I asked him to position upright during the day tilted a little bit sleeping on his left side at night and also he will need to do face down positioning. 10-15 minutes every hour or 2 for the next 2 days to avoid a macular fold. He will return for a check tomorrow, sooner should he notice a problem and see you regularly. Thank you for allowing me to participate in his care.
FU - VA was 20/40 3 months after procedure. The included photos are from 2 weeks after the procedure.
