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Case of the month: June 2021

Updated: Jul 13, 2021

BARA doctor Caesar Luo details his patient's symptoms and treatment in this Case of the Month.

Mr. KB is a 58-year-old gentleman who was an executive at a large regional company. He noted a 2-day history of some worsening dark floaters in the right eye, with small dots as well as long strands in the vision. He also began noticing quick flashes of light in the outer corner of his eye starting 1 day ago. He noted the flashes mainly at night, especially while driving. He did not have any trauma or injury prior to noticing the symptoms. He called his general ophthalmologist who directed him to see Bay Area Retina Associates immediately.

His family ocular history was positive only for cataracts, and he reported well-controlled high blood pressure for which he was taking lisinopril.

At the office, his vision was excellent at 20/20 in both eyes. He did not have any clear loss of peripheral vision, and his eye pressure was normal. Upon dilating his eyes, he was noted to have a large retinal tear in the right eye, as well as blood in the vitreous, or the jelly that fills the eye.

He was taken immediately for a laser procedure to wall off the retinal tear and prevent progression of the retinal tear into a full retinal detachment. The laser was applied and bright white laser spots were seen surrounding the entire retinal tear.

The patient was then asked to reduce strenuous activity and avoid any contact to the eye, and to return to the clinic in 1-2 weeks or sooner with any worsening of flashes, floaters, or a curtain in the vision. At 1 week the laser spots were turning darker, which is a sign that the retina is becoming sticky, preventing fluid from entering the retinal tear.

At 1 year, the patient continued to do very well without any progression of the retinal tear with excellent laser treatment. No further tears were noted, and he retained 20/20 vision. If Mr. KB had waited to be seen by a retina specialist, his retinal tear would likely have progressed into a complete retinal detachment, at which point surgery in an operating room would likely have been required and he may not have recovered his vision fully. If you or someone you know has been seeing new flashes of light in the outside of the vision, or new and increased floaters, or a new shadow or curtain in the vision, it is imperative that a retina specialist examine your eye quickly to achieve the best possible visual outcomes.

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