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Last additions - Macular Hole - Traumatic

11-year-old boy with a history of blunt trauma to the left eye yesterday. He reports he lost vision immediately but it has gotten somewhat better. He reports he sees “red streamers” and he has very blurry visual acuity. OPHTHALMIC EXAM: Visual acuity without correction of 20/20 OD, 20/200 OS. IOP: 15 OD, 14 OS. SLIT LAMP EXAM: Biomicroscopy reveals a quiet anterior segment on the right side with no cell or flare. The left side shows 10-20 cells/HPF with trace flare. There is no hyphema or red blood cell present. The lens is clear on both sides. The vitreous shows rare red blood cells in the anterior vitreous cavity of the left side. POSTERIOR SEGMENT EXAM: There is a well-formed vitreous cavity on both sides. There is some subhyaloid hemorrhage posterior on the left side at the posterior portion of the vitreous cavity. C/D ratio is 0.2 OU with a pink optic nerve. Large retinal vasculature is patent on both sides. The macula is smooth on the right and the macula on the left appears somewhat diffusely thickened with a partial thickness macular hole at the center with prominence of the foveal depression and irregularity of its edges. EXTENDED OPHTHALMOSCOPY: The retinal periphery is flat and attached with no tears, breaks, or detachments in the right. The left eye shows a superior swath of commotio retinae and some vitreous hemorrhage present anteriorly to it. With scleral depression, there is no tear, break, or detachment noted. OCT SCAN: OCT of the left eye shows a small neurosensory detachment with some thinning of the foveal tissue. There is no open macular hole. FUNDUS PHOTOGRAPHY: Color and red-free montage photographs of the left eye show commotio retinae superiorly and vitreous hemorrhage. This view is somewhat hazy secondary to anterior segment cell. There is prominence of the foveal depression and evidence of the partial thickness macular hole. IMPRESSION: 1. TRAUMATIC IRITIS LEFT EYE 2. COMMOTIO RETINAE LEFT EYE 3. VITREOUS HEMORRHAGE LEFT EYE 4. PARTIAL THICKNESS MACULAR HOLE FOLLOWING TRAUMA LEFT EYE OCT scan 1 week later shows full thickness macular hole

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Macular Hole - Traumatic - 11 year old boy (also retinal whitening Berlins Edema)236 views11-year-old boy with a history of blunt trauma to the left eye yesterday. He reports he lost vision immediately but it has gotten somewhat better. He reports he sees “red streamers” and he has very blurry visual acuity., 20/200 OS
1 week post injury and 1 month later (not shown here) mature full thickness macular hole.
May 13, 2011
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Macular Hole - Traumatic - 11 year old boy (also retinal whitening Berlins Edema)188 views11-year-old boy with a history of blunt trauma to the left eye yesterday. He reports he lost vision immediately but it has gotten somewhat better. He reports he sees “red streamers” and he has very blurry visual acuity., 20/200 OSMay 13, 2011
traumaticmachole06.jpg
Macular Hole - Traumatic - 11 year old boy (also retinal whitening Berlins Edema)243 views11-year-old boy with a history of blunt trauma to the left eye yesterday. He reports he lost vision immediately but it has gotten somewhat better. He reports he sees “red streamers” and he has very blurry visual acuity., 20/200 OSMay 13, 2011
traumaticmachole05.jpg
Macular Hole - Traumatic - 11 year old boy (also retinal whitening Berlins Edema)178 views11-year-old boy with a history of blunt trauma to the left eye yesterday. He reports he lost vision immediately but it has gotten somewhat better. He reports he sees “red streamers” and he has very blurry visual acuity., 20/200 OSMay 13, 2011
traumaticmachole04.jpg
Macular Hole - Traumatic - 11 year old boy (also retinal whitening Berlins Edema)153 views11-year-old boy with a history of blunt trauma to the left eye yesterday. He reports he lost vision immediately but it has gotten somewhat better. He reports he sees “red streamers” and he has very blurry visual acuity., 20/200 OSMay 13, 2011
traumaticmachole03.jpg
Macular Hole - Traumatic - 11 year old boy (also retinal whitening Berlins Edema)128 views11-year-old boy with a history of blunt trauma to the left eye yesterday. He reports he lost vision immediately but it has gotten somewhat better. He reports he sees “red streamers” and he has very blurry visual acuity., 20/200 OSMay 13, 2011
traumaticmachole02.jpg
Macular Hole - Traumatic - 11 year old boy (also retinal whitening Berlins Edema)154 views11-year-old boy with a history of blunt trauma to the left eye yesterday. He reports he lost vision immediately but it has gotten somewhat better. He reports he sees “red streamers” and he has very blurry visual acuity., 20/200 OSMay 13, 2011
traumaticmachole01.jpg
Macular Hole - Traumatic - 11 year old boy (also retinal whitening Berlins Edema)159 views11-year-old boy with a history of blunt trauma to the left eye yesterday. He reports he lost vision immediately but it has gotten somewhat better. He reports he sees “red streamers” and he has very blurry visual acuity., 20/200 OSMay 13, 2011
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11-year-old boy with a history of blunt trauma to the left eye yesterday. He reports he lost vision immediately but it has gotten somewhat better. He reports he sees “red streamers” and he has very blurry visual acuity. OPHTHALMIC EXAM: Visual acuity without correction of 20/20 OD, 20/200 OS. IOP: 15 OD, 14 OS. SLIT LAMP EXAM: Biomicroscopy reveals a quiet anterior segment on the right side with no cell or flare. The left side shows 10-20 cells/HPF with trace flare. There is no hyphema or red blood cell present. The lens is clear on both sides. The vitreous shows rare red blood cells in the anterior vitreous cavity of the left side. POSTERIOR SEGMENT EXAM: There is a well-formed vitreous cavity on both sides. There is some subhyaloid hemorrhage posterior on the left side at the posterior portion of the vitreous cavity. C/D ratio is 0.2 OU with a pink optic nerve. Large retinal vasculature is patent on both sides. The macula is smooth on the right and the macula on the left appears somewhat diffusely thickened with a partial thickness macular hole at the center with prominence of the foveal depression and irregularity of its edges. EXTENDED OPHTHALMOSCOPY: The retinal periphery is flat and attached with no tears, breaks, or detachments in the right. The left eye shows a superior swath of commotio retinae and some vitreous hemorrhage present anteriorly to it. With scleral depression, there is no tear, break, or detachment noted. OCT SCAN: OCT of the left eye shows a small neurosensory detachment with some thinning of the foveal tissue. There is no open macular hole. FUNDUS PHOTOGRAPHY: Color and red-free montage photographs of the left eye show commotio retinae superiorly and vitreous hemorrhage. This view is somewhat hazy secondary to anterior segment cell. There is prominence of the foveal depression and evidence of the partial thickness macular hole. IMPRESSION: 1. TRAUMATIC IRITIS LEFT EYE 2. COMMOTIO RETINAE LEFT EYE 3. VITREOUS HEMORRHAGE LEFT EYE 4. PARTIAL THICKNESS MACULAR HOLE FOLLOWING TRAUMA LEFT EYE OCT scan 1 week later shows full thickness macular hole