57 Female patient came to the out-patient clinic, She was asking for reading glasses. as she informed me that her right eye is not seeing. i started to be interested for more details than her request.
ok, let’s ask about general history of other diseases :
Diabetic ? No
Hypertensive? No
Cardiac or respiratory diseases? No
Any other diseases? No
Any current medications? NO
That’s really GREAT !
ok, tell me about your right eye “Not seeing one” ?
Patient talking; i had previous retina issue, my be retinal hemorrhage, i had 2 surgeries done, one for the retina and one for the silicon.
Apparently the patient had done vitrectomy, removal of hemorrhage, by examination she also had done crystalline lens removal and iol implantation. then she had done silicon oil removal after few months.
Hmm,
Lets move to left eye in history, she told that she never had any surgeries or any kind of interventions in her left eye.
Visual Acuity
Visual Acuity in right eye : Hand motion
Visual Acuity in left ye : 200/200
The left eye looks promising so far
Slit lamp Examination
Right eye : posterior capsular opacifications , no other signs
Left eye : looks fine
Fundus Examination
After dilating the pupils,
The right eye : Foveal scar ! which explains the Hand motion Visual acuity
The Left eye : Retinal Detachment.
wait a minute!
RD in left eye?
without any complaint from the patient?
with 200/200 VA ? That was a mind blowing for me.
Unfortunately the right eye retina were not able to be visualized on my phone due to the PCO, But here is a look on the RD in left eye :
And that was a one more sad story, about a patient who came for reading glasses to accidently discover a serious problem.
The patient was planning to travel outside the country but sadly, i had to tell her that we have a serious problem to resolve.
Share your thoughts, how would you manage such a case?
RETINAL IMAGING BY YOUR SMARTPHONE
