Remember in a past blog recently how I mentioned about retinal detachments? Well today as it turns out, I had a patient that had something that suspiciously looked like one. It wasn't a full blown retinal detachment since it was determined that the retina appeared flat. However, there were some suspicious signs like a vitreous haze that was more evident under BIO and I was able to see thru it easier under a fundus lens. But the biggest thing I learned today when it comes to suspicion of retinal detachment is to always look for pigmented cells in the vitreous. It it one of the telltale signs of a retinal detachment - if you look just behind the lens, you can see these tiny little brown pigmented specks floating about. The patient I saw this morning had only like 2-3 of them, and my staff doctor was the one who spotted them (I checked them out afterwards too, and they were indeed very subtle). But do understand that in more severe retinal detachment cases the specks would be more numerous. My staff doctor ended up calling the retina flat in the area of suspicion but referred it out to the ophthalmology department anyway.

So the key pearl for this blog is to make sure that if a patient complains of the symptoms of a retinal detachment, always check for the following (note that this is not a comprehensive list!) - tears, holes, possible traction, PVDs (see the last blog), and lastly, pigmented cells in the vitreous. If you don't spot any of these, definitely note the negatives e.g. state "no holes, tears, retinal detachments, PVDs, or pigmented cells...it's an important aspect of recordkeeping and when it comes to "covering your butt" (e.g. lawsuits)!!!

Last week I had a patient with multiple health and ocular problems. He was a 60? (I forget the exact age) year old Hispanic male presenting with a chief complaint of temporary loss of vision in both eyes. He explains to me that the loss of vision was as if the lights went dim, and it lasted for about 10 minutes then it went away on its own.

Read more »

This past Friday I saw a patient with a history of a retinal detachment (aka an "RD"). This patient had a history traumatic injury (a blow to the head) which caused the layers in the back of his eye (the retina) to peel off, causing him to go blind in the left eye. This is one of the scariest things that eye care doctors have to face, so patients are always advised to see their eye doctor as soon as they experience the symptoms of an RD. Symptoms include multiple showering of tiny black dots ("floaters") and flashes of light; patients can also experience a translucent "shadow" or "curtain" over their vision. If patients experience this, they are advised to see their eye doctor immediately since vision can be lost within a matter of hours. Even scarier, RDs can happen spontaneously! Thankfully, RDs are very rare but it's still something that eye doctors would have a really really bad day if they miss it while doing a dilated eye exam. In fact, this is one of the reasons why dilated exams can be so important because RDs are extremely difficult to catch if the patient is undilated.

Read more »