Myopic Tilted Optic Nerves
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82-year-old man was seen in the office on 7/21/2009. He had an injury when he was a child. The right eye unfortunately has had poor vision since. He had cataract extraction and then he had retinal detachment repair in the right eye in 1961. He has strabismus. He is not bothered by the strabismus very much because the right eye is uncorrected, although he is so nearsighted, even without a lens, he sees some out of the right eye. His left eye has had a little bit of a decline in vision over the last few months and he is understandably concerned about that because the left eye is his good seeing eye. He notices primarily when he watches t.v. it is a little difficult to read the writing on the television set.
VISUAL ACUITY: Vision OD is 20/100, OS is 20/20. IOP: OD 14, OS 10.
SLIT LAMP EXAM: The right eye has an iridocorneal adhesion and he is aphakic. The left eye has a posterior chamber intraocular lens in good position with 1+ posterior capsular opacity.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.6. The nerve is tilted. The macula is atrophic. The retina is attached on a moderate buckle. There is no intraretinal or subretinal fluid.
OS: Vertical C/D ratio is 0.3. The nerve is tilted. Again, there is patchy nongeographic atrophy of the macula and there is no intraretinal or subretinal fluid.
OCT SCAN: There is retinal atrophy in both eyes. There is no intraretinal or subretinal fluid. The foveal architecture in the left eye is nearly normal.
PHOTOGRAPHS: Photos confirm clinical findings.
IMPRESSION:
1. MYOPIC MACULAR DEGENERATION – BOTH EYES
2. HISTORY OF RETINAL DETACHMENT REPAIR – RIGHT EYE
3. APHAKIA – RIGHT EYE
4. IRIDOCORNEAL ADHESION – RIGHT EYE
5. STRABISMUS
DISCUSSION: I explained to the patient the maculae are stable and dry. I suggested he continue the eye vitamins.
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Myopic - Tilted - Optic Nerves with Torsion1079 views 82-year-old man He had an injury when he was a child. The right eye unfortunately has had poor vision since he is so nearsighted, even without a lens, he sees some out of the right eye. Vision OD is 20/100, OS is 20/20. 
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Myopic - Tilted - Optic Nerves with Torsion900 views 82-year-old man He had an injury when he was a child. The right eye unfortunately has had poor vision since he is so nearsighted, even without a lens, he sees some out of the right eye. Vision OD is 20/100, OS is 20/20.
(0 votes)
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Myopic - Tilted - Optic Nerves with Torsion908 views 82-year-old man He had an injury when he was a child. The right eye unfortunately has had poor vision since he is so nearsighted, even without a lens, he sees some out of the right eye. Vision OD is 20/100, OS is 20/20.
(0 votes)
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Myopic - Tilted - Optic Nerves with Torsion1017 views 82-year-old man He had an injury when he was a child. The right eye unfortunately has had poor vision since he is so nearsighted, even without a lens, he sees some out of the right eye. Vision OD is 20/100, OS is 20/20.
(0 votes)
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82-year-old man was seen in the office on 7/21/2009. He had an injury when he was a child. The right eye unfortunately has had poor vision since. He had cataract extraction and then he had retinal detachment repair in the right eye in 1961. He has strabismus. He is not bothered by the strabismus very much because the right eye is uncorrected, although he is so nearsighted, even without a lens, he sees some out of the right eye. His left eye has had a little bit of a decline in vision over the last few months and he is understandably concerned about that because the left eye is his good seeing eye. He notices primarily when he watches t.v. it is a little difficult to read the writing on the television set.
VISUAL ACUITY: Vision OD is 20/100, OS is 20/20. IOP: OD 14, OS 10.
SLIT LAMP EXAM: The right eye has an iridocorneal adhesion and he is aphakic. The left eye has a posterior chamber intraocular lens in good position with 1+ posterior capsular opacity.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.6. The nerve is tilted. The macula is atrophic. The retina is attached on a moderate buckle. There is no intraretinal or subretinal fluid.
OS: Vertical C/D ratio is 0.3. The nerve is tilted. Again, there is patchy nongeographic atrophy of the macula and there is no intraretinal or subretinal fluid.
OCT SCAN: There is retinal atrophy in both eyes. There is no intraretinal or subretinal fluid. The foveal architecture in the left eye is nearly normal.
PHOTOGRAPHS: Photos confirm clinical findings.
IMPRESSION:
1. MYOPIC MACULAR DEGENERATION – BOTH EYES
2. HISTORY OF RETINAL DETACHMENT REPAIR – RIGHT EYE
3. APHAKIA – RIGHT EYE
4. IRIDOCORNEAL ADHESION – RIGHT EYE
5. STRABISMUS
DISCUSSION: I explained to the patient the maculae are stable and dry. I suggested he continue the eye vitamins.
