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Pathology - Central Retinal Artery Occlusion - 6 weeks old - Inner Retinal Atrophy797 viewspatient died about 6 to 8 weeks after the artery occlusion, and he had no history of glaucoma. The inner retina atrophy, which looks very similar to that caused by COAG, is due to recent infarct.
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ECTOPIC DISCIFORM SCAR/PERIPHERAL CHOROIDAL NEOVASCULAR MEMBRANE – EXUDATE –INFLAMMATION IN REACTION TO THE PERIPHERAL VASCULAR LESION 797 views53-year-old woman has noticed some blurred vision in the right eye for a few years. In retrospect, she thinks it is possible since she was a teenager the right eye was always the weaker eye and that the left eye has always been the better eye. VISUAL ACUITY: Vision OD is 20/400
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4-up of Cornea Ulcer with Iris Prolaps797 views
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Macular Pucker Post-OP 20/30796 views
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Retinal Arterial Macroaneurysm - Recurrent Hemorrhage 6 months post laser796 views6 months post laser: Her vision had improved, but then three weeks ago it worsened again. She is not on any blood thinners. She wasn’t doing any heavy lifting or straining.
VISUAL ACUITY: OD 3/200
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Prefoveal Opercula after Aborted Stage 2 Macular Hole - Present for 1 Year - VA 20/20 - OCT796 viewsThis pleasant 61-year-old man had a small Stage 2 macular hole, which spontaneously close 12 months ago. He is still bothered by a pre-foveal opercula. OD 20/20.
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Retinal Arterial Macroaneurysm - Ruptured - Vitreous Hemorrhage (Fresh) 5/200 Vision796 views80-year-old woman has a retinal arterial macroaneurysm in the right eye I saw two years ago. She noticed the sudden onset of vision loss last night. OD is 5/200.
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Non-Ischemic Central Retinal Vein Occlusion in Young Man (30 years) - Many Cotton Wool Spots796 views30-year-old man with a history of a central retinal vein occlusion for which he was first examined on 2 months ago and his vision then was 4/200. He responded nicely to two Avastin treatments. OD is 20/20, OS is 20/60
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Cilioretinal artery occlusion and Ophthalmic Artery Occlusion with Relative Sparing of the Central Retinal Artery796 views80-year-old woman who says she was looking in the mirror, covered her right eye and noticed she could not see well out of the left eye. That just happened yesterday. Her last eye check was a few years ago. She also had a carotid endarterectomy on the right side in 2006 shortly after coronary bypass surgery. OD is 20/40, OS is 20/200.
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Stargardt's Macular Dystrophy796 views62 year old man with good vision
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Acute Zonal Occult Outer Retinopathy795 views45-year-old man noticed a few years ago peripheral vision blurriness in the left eye and also some central vision loss. Previous to that, as far as he knows, the two eyes were okay.
VISUAL ACUITY: OD: 20/20; OS: 20/40.
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Asteroid Hyalosis After Vitrectomy (also reticular drusen)795 views
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Central Serous Retinopathy Acute - Fluorescein Angiogram795 views42-year-old man was seen in the office on October 5, 2011. He had noticed starting in August after a course of antibiotic and steroids, that he developed new spots in his vision in the right eye. He may have had an episode like this sometime in the past. He did take steroids a few years ago and his vision did change at that time, but then returned.
VISUAL ACUITY: OD 20/32, OS 20/32
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Myelinated Nerve Fiber Layer795 views69-year-old woman OD is 20/30, OS is 20/40.
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Asymptomatic Occult Subfoveal CNVM in Good Eye Visible on ICG795 views
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Choroidal Thickening795 views78 year old man followed for 4 months with choroidal thickening. Cursory systemic evaluation with no imaging shows no cancer. Vision is stable or improving.
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Chronic Retinal Detachment and Macular hole Post-Op794 views51-year-old woman about 3 or 4 months ago she noticed some flashing lights. Her vision became hazy and dark, especially when she was covering her left eye. OD 2/200, OS 20/20. Post op vision 20/200.
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Central Serous Retinopathy - Acute794 views49-year-old man sees a spot in the central vision with a red halo for 2 weeks OD is 20/50, OS is 20/20
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Papilledema post-spinal tap va 20/25794 views24-year-old woman was seen in the office on 2/23/2010. She has had noticed positional blurring of her vision when she bends over since around November. When she bends over and stands up straight, she notices her vision is blurred. Vision OD is 20/100, PH 20/40; OS is 20/80, PH 20/30. IOP: 19 OU.
vision was 20/25 after tap
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794 views
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Retinal Tear with Vitreous Hemorrhage before and after Laser Photocoagulation794 views61-year-old man has noticed increased floaters in the right eye for about the last week. Vision OD is 20/160 There is 3+ vitreous hemorrhage with a retinal tear, about 2-disc diameters posterior to the equator at 10:00 o’clock over a retinal vessel.
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Sectoral Optic Atrophy from an old Branch Retinal Artery Occlusion 794 views74-year-old woman had cataract surgery 3 months ago. Her vision in the right eye has been abnormal since. She notices a shadow in the inferior vision in the right eye. OD is 20/60, OS is 20/50
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Ocular Histoplasmosis both Eyes - Laser Right Eye Only SD-OCT794 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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Three years after Injury - Optic Atrophy - Vision is 1/200 in each eye793 views
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Crystalline retinopathy associated with chronic retinal detachment (Macular Crystals)793 views54-year-old man with an asymptomatic chronic inferotemporal retinal detachment (10 years old) OD 20/25, OS 20/30
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Serous Macular Detachment Both Eyes - Wet AMD vs. CSR - 62 Year Old Man - SD - OCT793 views
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Papilledema - Sagittal Cerebral Vein Thrombosis - Lung Transplant Cystic Fibrosis 36 Year Old Man793 viewsColor Photo
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PVR_preop793 viewsScott Pautler, MD
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Retinal Torsion after Macula Off Retinal Detachment Repair with Inferior PVR792 views37 year old with torsion of the retina after macula off retinal detachment repair with inferior PVR and membranes dragging the fovea inferiorly.
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Retinal Arterial Macroaneurysm - Normal Vision (2 Years before rupture)792 views78-year-old woman has a retinal arterial macroaneurysm in the right eye. VA 20/25 (pre-rupture photos)
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Cartwheel CNVM - Classic - wet AMD - evidence of possible old CSR792 views75 y.o Decreased Vision right eye for one year. VA OD: sc20/125+2 OS 20/25. Autofluorescence and SD OCT show evidence of old serous retinal detachment superior to the fovea suggesting a history of CSR. The macular lesion on FA shows a classic cartwheel appearance
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Plaquenil (Hydroxycholorquine) Toxicity - Bull's Eye Maculopathy - 73 year old womand 25 Years therapy - 64 inches tall - 110 lbs791 views73-year-old woman has been on Plaquenil for twenty five years. She noticed loss of paracentral vision a few months ago. VISUAL ACUITY: OD 20/70, OS 20/30. Her color vision was 0 out 10 correct in both eyes and she also missed the controls.
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Hemicentral Retinal Vein Occlusion Vision 20/60 791 views84-year-old man has a hemicentral retinal vein occlusion in the right eye. His vision has declined since then.
VISUAL ACUITY: Vision OD is 20/60.
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Proliferative Diabetic Retinopathy and Mild Vitreous Hemorrhage791 views58-year-old woman has diabetic retinopathy in both eyes with neovascularization of the optic nerve, worse in the right eye than the left eye. Vision OD is 20/25, OS is 20/20
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Pattern Dystrophy - Congenital Deafness - Diabetes - Developmental Delay - Fundus Photo Left Eye - Yellow Submacular Deposits790 views45-year-old woman congenitally deaf. She has diabetes for the last two years. She also has developed mental delay and memory problems. OD 20/200, OS 20/50. She has sluggish pupillary responses in both eyes.
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DUSN - Diffuse Unilateral Subacute Neuroretinitis - Nematode790 views
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790 views
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Classic BRVO790 viewsClassic branch retinal vein occlusion
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Normal Tension Glaucoma - Nerve Fiber Layer Scan is difficult to read because of artifact from peripapillary atrophy790 views90 Year old man: IOP 9 OD, 11 OS
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Exogenous Fungal Endophthalmitis790 views69 year old female with endophthalmitis 2 months after ECCE. Treated with vitrectomy and 3 injections of amphotericin B. Vision improved from 5/200 - 20/50
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Pseudophakic Macula-Off Retinal Detachment with Larger Retinal Tear789 views68-year-old woman with veil over her vision just the last few days. She had cataract surgery a year ago. OD 20/200 -- One year later vision 20/30!
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Retinal Pigment Epithelial Dysgenesis789 views
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Patterned Pigment Dystrophy of the Fovea 79 YO Woman VA 20/20 Right 20/30 Left789 views
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Stage 2 20/100 Idiopathic Macular Hole789 views62-year-old woman has a macular hole in the left eye. Her vision is worse than when she was here 1 month ago with a 100 micron hole
VISUAL ACUITY: OS 20/100.
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Birdshot Chorioretinitis - Retinal Vasculitis - HLA A29 Positive 789 views64-year-old woman three or four year’s fluctuations in her vision. She mostly notices them in bright light her vision glares out and she has difficulty seeing. PMHx: malaria in 1948 that was treated. She was told at one point she could possibly have had Familial Mediterranean fever.
She does intermittently get rashes around her arms. She has arthritis in her knees and ankles.
VISUAL ACUITY: OD 20/40, OS 20/50 - HLA - A29 Positive
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Plaquenil Toxicity - Bull's Eye Maculopathy - 25 Years Therapy - OCT Line Scan789 views73-year-old woman has been on Plaquenil for twenty five years. Plaquenil has now been stopped for 6 months. VA continues to decline as does visual function - 20/80 OD , 20/40 OS
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Tick on Lower Lid789 viewsPt. came in for cataract surgery and a tick was found on the lower lid. Pt. had no idea the tick was attached and did not know how long it had been there. Tick was photographed and then removed by physician.
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Malignant Hypertension - Cotton Wool Spots - Elschnig Spots - Optic Nerve Edema 789 views6 week fu - CWS are Fading
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Drusen Maculopathy - Confluent Subfoveal Soft Hydrophobic Drusen - Early Fluorescein Angiogram Drusen do not yet Stain788 views73-year-old woman. She is diabetic for thirteen years. She is also on Coumadin for her heart disease.
VISUAL ACUITY: OD 20/25, OS 20/50.
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Stargardt's Disease - Macular Dystrophy - 69 Year Old African American Male - 20/200 both eyes788 views69-year-old man has had vision loss in both eyes starting 20 years ago. He was diagnosed at one point with Stargardt’s macular dystrophy. When I saw him, he had retinal atrophy in each eye.
Vision is 20/200 in each eye
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periphery 3. od788 viewsleaking miliary aneurysms
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Reticular Macular Disease (Pseudo-drusen) Both Eyes - Occult CNVM and Macular Edema Right Eye 788 viewsSpectral Domain Optical Coherence Tomography
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Retinal Torsion after Macula Off Retinal Detachment Repair with Inferior PVR787 views37 year old with torsion of the retina after macula off retinal detachment repair with inferior PVR and membranes dragging the fovea inferiorly.
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Dense Vitreous Floater (opacity) from Vitreous Separation 787 views71-year-old woman with a lamellar macular hole in the left eye and also a dense vision floater in the left eye. OD 20/30, OS 20/25
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69 Year Old Woman Normal Fluorescein Angiogram787 views69-year-old woman OD 20/50 - OS 20/30 ATYPICAL PHOTOPSIAS
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Central Retinal Artery Occlusion less than 24 hours - 69 year old man VA light perception786 views
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Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS786 views63-year-old woman has serpiginous choroiditis (date - March 2011). The right eye has not been previously involved, and then she noticed new onset floaters in the right eye for the last two weeks. Her vision in the right eye is hazy because of that.
VISUAL ACUITY: Vision OD is 20/25, OS is 20/50
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786 viewsPHPV - Left eye macular area. The patient was diagnosed as having regressed ROP even with a history of full term birth with no antecedent perinatal history of disease
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Dehydration Injury to Retina after Macula-On Retinal Detachment Repair - Also Subretinal Perfluoron786 views18 month ago he had a scleral buckle, vitrectomy, laser and gas for macula on retinal detachment. Since he notices blind spots in the center of the left eye/ He also notices a dense, inferior visual field defect. OD 20/20, OS 20/50
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Glaucomatous optic nerve with severe cupping786 views
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Optic Nerve Pit Retinal Detachment - Macular Detachment - 8 Year Old - 5/200 Vision OS785 views8-year-old child on two school exams that his vision was poor in the left eye and his last normal exam was in preschool.
VISUAL ACUITY: OD 20/30, OS 5/200. OS: Vertical C/D ratio is 0.2. There is a whitening on the temporal edge of the optic nerve consistent with an optic disc pit and there is a serous macular detachment.
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Fundus Autofluorescence - Enhanced S Cone Syndrome - Goldmann Favre - 785 views55-year-old woman while in college her vision was poor even with glasses and she sought evaluation for that. She was told after she had an electroretinogram at USF 15 years ago, that she had something with her blue cones. She does have poor night vision, but her reading vision is pretty good.
VISUAL ACUITY: OD 20/40, OS 20/40
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Congenital Toxoplasmosis with non-macular Scars Both Eyes - Recent Reactivation (recurrence) Right Eye785 views34-year-old man has congenital toxoplasmosis with four week history of foggy vision and new floaters in the right eye. OD is 20/40, OS 20/30
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Myelinated Nerve Fiber Layer785 views69-year-old woman OD is 20/30, OS is 20/40.
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Conjunctival Vascular Anomaly785 viewsPatient presents a vascular pattern of blood vessels @ 10 o'clock of the superior-temporal quadrant of the right eye. Patient has had flare ups with anterior scleritis in the past which is controlled by Methotrexate. Patient's VA is currently 20/40 with PH 20/30, right eye.
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Red Free of Hollenhorst Plaque785 viewsRed free fundus photo of patient with multiple hollenhorst plaque
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Vision Loss, Blood, and Cartwheel CNVM OD with no fluid on OCT Scan784 views86-year-old man has had changing vision. He says his vision has been gradually declining since I saw him in June. You saw a hemorrhage in the eye and suggested he comes in here for an evaluation. He is on Combigan and Travatan in the right eye for his glaucoma.
VISUAL ACUITY: Vision OD is 6/200 OS is 8/200 The macula in the right eye is wet even though interestingly the OCT does not show subretinal fluid.
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Vitreomacular traction - recent vision loss Right Eye - initially worse after Jetrea then better784 views
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Sclerochoroidal Calcification - 72 Year Old Woman 783 views72-year-old woman who has spots on her lungs, which she has been told are scar tissue 20/30 OU
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Non-Arteritic Anterior Ischemic Optic Neuropathy - Peripapillary Choroidal Ischemia783 views68-year-old woman noticed central vision loss in the right eye about a week ago. It is getting a little bit better. OD 20/160, OS 20/25.
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Vitreomacular Traction 3 months - 20/60 vision - Fellow Eye Normal - 80 Year Old Man SD - OCT783 views80-year-old man has a macular pucker in the right eye with vitreomacular traction and vision loss for 3 months. His vision seems about stable to him. OD 20/60.
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Best Vettiliform Dystrophy with CNVM-4783 views
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Hyperpigmentation of the Retinal Pigment Epithelium Right Eye (Treated wet AMD OS)783 views85-year-old man has wet age-related macular degeneration in the left eye treated for one year most recently one year ago. OD is 20/30, OS is 20/60
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Silicone Oil in the Anterior Chamber783 viewsPatient comes in for second opinion for retinal detachment in the left eye. VA is hand motion in the left eye. Poor view to look into the retina. Small silicone bubble at 12 o'clock superior in the anterior chamber. Surgery was not recommended due to the silicone oil in the left eye.
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Polychromatic Cataract (Christmas Tree Cataract)783 viewsPatient comes in with cataract evaluation. Blurred vision in the left eye. Patient will think about surgery and call back to schedule.
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Basal Laminar Drusen - Cuticular Drusen - 19 Year Old with Lupus Nephritis782 views19-year-old. She has a history of developing severe systemic lupus erythematosus in 2001. She was in renal failure and had biopsy proven Class 2 lupus nephritis. She is currently on Plaquenil 400 mg for six years, as well as Prednisolone orally, every other day. OD 20/20, OS 20/25.
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Acute Zonal Occult Outer Retinopathy782 views45-year-old man noticed a few years ago peripheral vision blurriness in the left eye and also some central vision loss. Previous to that, as far as he knows, the two eyes were okay.
VISUAL ACUITY: OD: 20/20; OS: 20/40.
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Plaquenil Toxicity with New Symptomatic Scotoma Left Eye782 views64-year-old female decreased vision OS over the past 2 months. She describes a blurred central scotoma. She has rheumatoid arthritis and is on Plaquenil 200 mg BID for 15 years. She does have yearly visual field tests done with last visual field test performed 3 years ago which was within normal limits OD 20/40-2 OS 20/40-1
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Hyperpigmentation of the Retinal Pigment Epithelium Right Eye (Treated wet AMD OS)782 views85-year-old man has wet age-related macular degeneration in the left eye treated for one year most recently one year ago. OD is 20/30, OS is 20/60
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Acute Posterior Multifocal Placoid Pigment Epitheliopathy - APMPPE - Fluorescein Angiogram782 views 25-year-old man with one and half weeks ago he woke up with night chills. Also around that time his joints started hurting him. He also has headaches, although the headache at this point is not severe. His vision has been changing for about the last week and a half. He sees some spots in his vision and they are blurred spots. They are not in the central vision.
VISUAL ACUITY: OD 20/32, OS 20/32
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Anomalous Branch Retinal Artery 781 views59-year-old man OD 20/25, OS 20/25. TORTUOUS RETINAL ARTERY – LEF EYE
(POSSIBLE GROUP 2 WYBURN-MASON SYNDROME
POSSIBLE ACEPHALIC MIGRAINES )
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Acute Annular Outer Retinopathy for 3 Months - 25 YO Female OCT Movie781 views25-year-old female who, about three months ago, put on her sunglasses and noticed a smudge in the vision and at that point she noticed the right eye was hazy. She had a cold a week or two before the vision loss, but she didn’t have any fever. She has no focal neurological problems in her past history. VA 20/20 OU
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Acute Central Serous Retinopathy - CSR - Steroid Induced (probably) - Good Vision - 6 months later - vision Better - FAF shows small abnormality781 views42-year-old man has central serous retinopathy in the right eye with serous retinal detachment. 6 month follow-up Vision is better.
VISUAL ACUITY: OD 20/20.
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Background Diabetic Retinopathy781 viewsPatient with diabetes for over 11-years comes in with blurred vision. Blood sugar control is very poor. VA 20/50- right eye, 20/25-left eye. Fundus exam shows hard exudates with Circinate Rings and edema. Micro-aneurysms and retinal hemorrhage are present in both eyes. Patient will come back for laser treatment.
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Ghost vessels with BRVO781 views
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Equatorial Drusen781 views61 year old female with normal visoin
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Occult Maculopathy - Thin Fovea on OCT and Normal Color VA, Photos, FA VA 20/80 OU780 views45-year-old man his mother and his maternal grandmother each had vision loss at a relatively young age. Macula OD
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Central Retinal Artery Occlusion - 2 months old by history780 views77-year-old man was doing fine. His left eye was a little worse than the right eye, and then in the 2 months ago he had sudden severe vision loss in the right eye. Vision OD is 3/200; OS is 20/60. IOP: OD 30, OS 15.
OD: Vertical C/D ratio is 0.4. The macula is white from ischemia. The arteries are narrow.
Photos confirm clinical findings.
OCT SCAN: OCT scan of the right eye shows retinal thickening, consistent with macular edema associated with a central retinal artery occlusion. The left eye has severe inferior retinal thinning, consistent with an old hemicentral retinal artery occlusion in the left eye. The fovea in the left eye is a little bit thin but not too bad.
IMPRESSION: 1. CENTRAL RETINAL ARTERY OCCLUSION RIGHT EYE
2 OLD HEMICENTRAL RETINAL ARTERY OCCLUSION LEFT EYE
3 DIABETES WITHOUT RETINOPATHY
4 ELEVATED INTRAOCULAR PRESSURE RIGHT EYE STATUS POST INJECTION RIGHT EYE A WEEK AGO
DISCUSSION: I explained to the patient that the right eye unfortunately has had a central retinal artery and unfortunately we do not have anything to treat that. His vision will probably improve some over time. He needs to be watched though. It is possible he is developing rubeotic glaucoma, although it is probable the intraocular pressure is high from the injection last week. I asked him to restart the Alphagan, to stop the other two drops, and to return here in three weeks to make sure his pressure is more acceptable.
At this point, having lost almost all the retinal circulation in the right eye and half of the retinal circulation in the left eye, he only has half a retina in the left eye he is working off of. I told him it is very important he keep seeing you and anything that can be done to keep his blood pressure low and his cholesterol reasonable would be helpful to what remains of his retinal circulation.
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Acute Zonal Occult Outer Retinopathy780 views45-year-old man noticed a few years ago peripheral vision blurriness in the left eye and also some central vision loss. Previous to that, as far as he knows, the two eyes were okay.
VISUAL ACUITY: OD: 20/20; OS: 20/40.
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Congenital Toxoplasmosis with non-macular Scars Both Eyes - Recent Reactivation (recurrence) Right Eye780 views34-year-old man has congenital toxoplasmosis with four week history of foggy vision and new floaters in the right eye. OD is 20/40, OS 20/30
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Malignant Hypertension - Cotton Wool Spots - Elschnig Spots - Optic Nerve Edema 780 views6 week fu - CWS are Fading
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Juxtapapillary CNVM and Serous Macular Detachment Wet AMD Rx Laser779 views85-year-old man OD is 20/25, OS is 20/100. IOP: OD 21, OS 22.
OS: Vertical C/D ratio is 0.1. There is a posterior vitreous separation. There is a hemorrhagic pigment epithelial detachment on the superior pole of the optic nerve, extending a disc-and-a-half diameter off the nerve, with adjacent exudates. There is a serous macular detachment involving the center of the fovea.
VA improved from 20/100 to 20/50 in four months from laser.
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Sclerochoroidal Calcification - 72 Year Old Woman 779 views72-year-old woman who has spots on her lungs, which she has been told are scar tissue 20/30 OU
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Retinal Arterial Atheromata779 views68-year-old woman with records going back 7 years, which clearly document retinal arterial plaques in both eyes.
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Superior Retinal Detachment - Bullous - Macula-off779 views70-year-old man noticed a shadow creeping over the vision in the left eye and he no longer sees well out of that eye. He had cataract surgery two years ago and a YAG capsulotomy six months ago.
VISUAL ACUITY: OD 20/20, OS 1/200
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Sturge-Weber Encephalotigeminal Angiomatosis - Facial Hemangioma and Asymptomatic Ipsilateral Diffuse Choroidal Hemangioma779 views61-year-old man with Sturge-Weber syndrome with a hemangioma on the left side of his face.
VISUAL ACUITY: Vision OD is 20/50, PH 20/30; OS 20/80, PH 20/30. IOP: OD 16, OS 19.
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AION Color779 views
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Punctate Inner Choroidopathy - PIC and Choroidal Neovascular Membrane - Right Eye - ICG Angiogram779 views34-year-old woman with a change in vision in the right eye about eight days ago. Her vision was hazy and she saw waviness in the vision. She does have a history of aches and pains and she was diagnosed with Sjogren’s and 2 months ago she had some fevers and some sinus drainage and that went on for about two months. She is a moderate myope. OD 20/25, OS 20/20.
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Confluent Soft Drusen with Subetinal Fluid - Right Eye779 viewsAsymptomatic 85 year old man. OCT shows pocket of subfoveal fluid in the center of the macula. This could be mechanical from the drusen preventing the retina from settling down. Testing did not reveal a CNVM and subsequent OCT 6 weeks later showed no change in structure.
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Shotgun Injury 2.5 Years later - 10/200778 viewson 4/5/2011. This pleasant 19-year-old had a gunshot injury to the face in December of 2008. He has had several surgeries and his vision is remarkably good. He is aphakic. He is not wearing his contact much but he notices no change. If anything, his vision is a little better.
VISUAL ACUITY: Vision OS is 10/200.
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