Ocular Histoplasmosis - Macular Scars
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58-year-old woman was seen in the office on January 4, 2012. She lost vision as a child in the left eye from ocular histoplasmosis. She used to play in her attic and she was told by her pulmonary doctor that is probably where she picked it up. She had laser in the right eye for a leaky lesion back in 1990. Her vision in the right eye remains good. Recently she is starting Plaquenil, because of her rheumatoid arthritis and prior to that, because she only has one eye, she is here for a Plaquenil screening.
VISUAL ACUITY: OD 20/25, OS 20/200. IOP: OD 13, OS 16.
SLIT EXAMINATION: The posterior chamber intraocular lens is in good position in both eyes. The left eye has an open capsule.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.4. There is a peripapillary scar. There are no chorioretinal scars right next to the fovea. There is one superior and inferior to the nerve.
OS: Vertical C/D ratio is 0.4. There is a large macular scar and peripapillary atrophy.
SPECTRALIS-SD-OCT SCAN: The OCT scan shows normal foveal contour in the right eye.
FUNDUS AUTO FLUORESCENCE: Fundus auto fluorescence in the very center of the fovea is normal in the right eye. The left eye has foveal atrophy and hypo auto fluorescence, because of a macular scar.
IMPRESSION:
1. OCULAR HISTOPLASMOSIS – BOTH EYES
2. MACULAR SCAR – LEFT EYE
3. PREVIOUS LASER – RIGHT EYE
DISCUSSION: I explained to the patient there is no retinal contraindication to Plaquenil therapy and she needs to be rechecked in about five years.
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Ocular Histoplasmosis both Eyes - Laser Right Eye Only 708 views58-year-old woman who lost vision as a child in the left eye from ocular histoplasmosis. She used to play in her attic and she was told by her pulmonary doctor that is probably where she picked it up. She had laser in the right eye for a leaky lesion back in 1990. OD 20/25, OS 20/200. 
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Ocular Histoplasmosis both Eyes - Laser Right Eye Only 479 views58-year-old woman who lost vision as a child in the left eye from ocular histoplasmosis. She used to play in her attic and she was told by her pulmonary doctor that is probably where she picked it up. She had laser in the right eye for a leaky lesion back in 1990. OD 20/25, OS 20/200.
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Ocular Histoplasmosis both Eyes - Laser Right Eye Only 641 views58-year-old woman who lost vision as a child in the left eye from ocular histoplasmosis. She used to play in her attic and she was told by her pulmonary doctor that is probably where she picked it up. She had laser in the right eye for a leaky lesion back in 1990. OD 20/25, OS 20/200.
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Ocular Histoplasmosis both Eyes - Laser Right Eye Only 443 views58-year-old woman who lost vision as a child in the left eye from ocular histoplasmosis. She used to play in her attic and she was told by her pulmonary doctor that is probably where she picked it up. She had laser in the right eye for a leaky lesion back in 1990. OD 20/25, OS 20/200.
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Ocular Histoplasmosis both Eyes - Laser Right Eye Only 480 views58-year-old woman who lost vision as a child in the left eye from ocular histoplasmosis. She used to play in her attic and she was told by her pulmonary doctor that is probably where she picked it up. She had laser in the right eye for a leaky lesion back in 1990. OD 20/25, OS 20/200.
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Ocular Histoplasmosis both Eyes - Laser Right Eye Only 621 views58-year-old woman who lost vision as a child in the left eye from ocular histoplasmosis. She used to play in her attic and she was told by her pulmonary doctor that is probably where she picked it up. She had laser in the right eye for a leaky lesion back in 1990. OD 20/25, OS 20/200.
(0 votes)
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Ocular Histoplasmosis both Eyes - Laser Right Eye Only 478 views58-year-old woman who lost vision as a child in the left eye from ocular histoplasmosis. She used to play in her attic and she was told by her pulmonary doctor that is probably where she picked it up. She had laser in the right eye for a leaky lesion back in 1990. OD 20/25, OS 20/200.
(0 votes)
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Ocular Histoplasmosis both Eyes - Laser Right Eye Only 488 views58-year-old woman who lost vision as a child in the left eye from ocular histoplasmosis. She used to play in her attic and she was told by her pulmonary doctor that is probably where she picked it up. She had laser in the right eye for a leaky lesion back in 1990. OD 20/25, OS 20/200.
(0 votes)
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Ocular Histoplasmosis both Eyes - Laser Right Eye Only 734 views58-year-old woman who lost vision as a child in the left eye from ocular histoplasmosis. She used to play in her attic and she was told by her pulmonary doctor that is probably where she picked it up. She had laser in the right eye for a leaky lesion back in 1990. OD 20/25, OS 20/200.
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Ocular Histoplasmosis both Eyes - Laser Right Eye Only SD-OCT488 views58-year-old woman who lost vision as a child in the left eye from ocular histoplasmosis. She used to play in her attic and she was told by her pulmonary doctor that is probably where she picked it up. She had laser in the right eye for a leaky lesion back in 1990. OD 20/25, OS 20/200.
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Ocular Histoplasmosis both Eyes - Laser Right Eye Only SD-OCT525 views58-year-old woman who lost vision as a child in the left eye from ocular histoplasmosis. She used to play in her attic and she was told by her pulmonary doctor that is probably where she picked it up. She had laser in the right eye for a leaky lesion back in 1990. OD 20/25, OS 20/200.
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Ocular Histoplasmosis both Eyes - Laser Right Eye Only InfraRed482 views58-year-old woman who lost vision as a child in the left eye from ocular histoplasmosis. She used to play in her attic and she was told by her pulmonary doctor that is probably where she picked it up. She had laser in the right eye for a leaky lesion back in 1990. OD 20/25, OS 20/200.
(0 votes)
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Ocular Histoplasmosis both Eyes - Laser Right Eye Only InfraRed444 views58-year-old woman who lost vision as a child in the left eye from ocular histoplasmosis. She used to play in her attic and she was told by her pulmonary doctor that is probably where she picked it up. She had laser in the right eye for a leaky lesion back in 1990. OD 20/25, OS 20/200.
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Ocular Histoplasmosis both Eyes - Laser Right Eye Only Fundus Autofluoresence503 views58-year-old woman who lost vision as a child in the left eye from ocular histoplasmosis. She used to play in her attic and she was told by her pulmonary doctor that is probably where she picked it up. She had laser in the right eye for a leaky lesion back in 1990. OD 20/25, OS 20/200.
(0 votes)
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Ocular Histoplasmosis both Eyes - Laser Right Eye Only Fundus Autofluoresence428 views58-year-old woman who lost vision as a child in the left eye from ocular histoplasmosis. She used to play in her attic and she was told by her pulmonary doctor that is probably where she picked it up. She had laser in the right eye for a leaky lesion back in 1990. OD 20/25, OS 20/200.
(0 votes)
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Ocular Histoplasmosis both Eyes - Laser Right Eye Only Fundus Autofluoresence619 views58-year-old woman who lost vision as a child in the left eye from ocular histoplasmosis. She used to play in her attic and she was told by her pulmonary doctor that is probably where she picked it up. She had laser in the right eye for a leaky lesion back in 1990. OD 20/25, OS 20/200. 
(1 votes)
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Ocular Histoplasmosis both Eyes - Laser Right Eye Only Fundus Autofluoresence465 views58-year-old woman who lost vision as a child in the left eye from ocular histoplasmosis. She used to play in her attic and she was told by her pulmonary doctor that is probably where she picked it up. She had laser in the right eye for a leaky lesion back in 1990. OD 20/25, OS 20/200.
(0 votes)
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58-year-old woman was seen in the office on January 4, 2012. She lost vision as a child in the left eye from ocular histoplasmosis. She used to play in her attic and she was told by her pulmonary doctor that is probably where she picked it up. She had laser in the right eye for a leaky lesion back in 1990. Her vision in the right eye remains good. Recently she is starting Plaquenil, because of her rheumatoid arthritis and prior to that, because she only has one eye, she is here for a Plaquenil screening.
VISUAL ACUITY: OD 20/25, OS 20/200. IOP: OD 13, OS 16.
SLIT EXAMINATION: The posterior chamber intraocular lens is in good position in both eyes. The left eye has an open capsule.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.4. There is a peripapillary scar. There are no chorioretinal scars right next to the fovea. There is one superior and inferior to the nerve.
OS: Vertical C/D ratio is 0.4. There is a large macular scar and peripapillary atrophy.
SPECTRALIS-SD-OCT SCAN: The OCT scan shows normal foveal contour in the right eye.
FUNDUS AUTO FLUORESCENCE: Fundus auto fluorescence in the very center of the fovea is normal in the right eye. The left eye has foveal atrophy and hypo auto fluorescence, because of a macular scar.
IMPRESSION:
1. OCULAR HISTOPLASMOSIS – BOTH EYES
2. MACULAR SCAR – LEFT EYE
3. PREVIOUS LASER – RIGHT EYE
DISCUSSION: I explained to the patient there is no retinal contraindication to Plaquenil therapy and she needs to be rechecked in about five years.
