The Importance Of Simultaneous Viewing

Larry J Alexander OD FAAO Monday, 20 January 2014

EYELESSONS.COM Disclaimer: The content provided herein is for educational and informational purposes only; nothing provided herein should be intended to create a physician-patient relationship or an offer for a contract and does not constitute medical diagnosis or advice. The opinion relating to a review of any issue presented or discussed is the sole responsibility of the healthcare provider or medical advisor. The doctor or patient must assume all liability, including, but not limited to, any direct, indirect, incidental, consequential, or any other monetary or other damages, or liabilities arising out of or relating in any way to the content  or information provided herein.

51 yo F

 

  - CC VISION CLOUDY BUT DOESN’T BOTHER HER UNLESS SHE COVERS OD
  - BCVA 20/20 OU
  - AG EDGES BLURRED OS AS IF LOOKING THROUGH SOMEONE’S HAND
  - RED CAP OS LIKE LOOKING THROUGH A VEIL
  - RETINAS APPEAR FINE
  - PLEASE REVIEW SCANS

 

EYELESSONS.COM Disclaimer: The content provided herein is for educational and informational purposes only; nothing provided herein should be intended to create a physician-patient relationship or an offer for a contract and does not constitute medical diagnosis or advice. The opinion relating to a review of any issue presented or discussed is the sole responsibility of the healthcare provider or medical advisor. The doctor or patient must assume all liability, including, but not limited to, any direct, indirect, incidental, consequential, or any other monetary or other damages, or liabilities arising out of or relating in any way to the content  or information provided herein. 

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OKAY DOCTORS, TELL ME YOUR OPINION AND WHAT YOU WOULD DO?

LESSON HERE IS THAT MORE INFORMATION IS NEEDED. WHAT DO THE FUNDUS PHOTOS REALLY SHOW?

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LET’S LOOK AT OD AND OS AT THE SAME TIME.

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WHAT DO YOU WANT TO DO NOW?

ANALYSIS

  • LESIONS IN OUTER RETINA THAT OCCUPY SPACE
  • UNTIL SIMULTANEOUS COMPARISON DIFFICULT TO SEE
  • RETINAL THINNING CORRESPONDS TO AREAS OF ORANGE VARIATION IN RETINAL PHOTOS
  • VF CORRESPONDS TO AREAS OF ORANGE VARIATION IN RETINAL PHOTOS
  • NO OTHER SIGNS OR SYMPTOMS

CONSIDER

  • WHAT IS THE SOURCE OF THE SPACE OCCUPYING LESIONS THAT TAKE ON AN ORANGE HUE
  • FURTHER TESTING INCLUDING SYSTEMIC CONSIDERATIONS IS WARRANTED

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Caveat: When using any guidelines one must consider correlation with other patient characteristics and other clinical tests such as but not limited to: chief complaint, age, gender, ethnicity, refractive status, family history, associated medical conditions, current medications, pachymetry, visual field testing, angle assessment.

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About the Author(s)

Larry J Alexander OD FAAO

Larry J Alexander OD FAAO

Dr. Alexander (1948-2016) was a 1971 graduate of Indiana University School of Optometry. He served in the US Navy then served as a Professor at the University of Alabama Birmingham School of Optometry. Larry contributed to a number of chapters in textbooks and has published three editions of Primary Care of the Posterior Segment, as well as contributed to the professional literature. He also lectured extensively in the area of ocular and systemic disease. His areas of special interest included dysfunctional tear syndrome, glaucoma and macular degeneration.  His lessons are the basis for this site and he will be dearly missed. 

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