In a previous blog, I mentioned briefly about Posterior Vitreous Detachments (PVDs)...well as it turns out, today I saw another PVD and the patient had a classic appearance of the vitreous right behind the eye. However, it can be very difficult to detect if you don't know what it looks like. After searching far and wide in the internet, I couldn't find a good picture of what it looks like, but turns that I found something even better - a video! Please check out the following link to see the video:
http://www.ophthobook.com/videos/retina-basics-video
This video from YouTube also describes how a PVD occurs:
http://www.youtube.com/watch?v=SGJn4h0n5LQ
Hopefully after you see this video you'll be able to detect PVDs as seen behind the crystalline lens!
Learn Something New #8: Posterior Vitreous Detachment (PVD) video
July 01, 2009Clinical case: Retinal detachment?
June 22, 2009
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)!!!
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)!!!
Clinical case: Multiple issues in one patient
June 15, 2009
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.
