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64 year old female The patient has a macular pucker and some funky things in the left eye. There is an after image that is getting worse. When she blinks she sees a dark spot that is like a squiggle especially with contrast. She can ignore the left eye. When she is tired the vision in the left eye is dark and smudgy. This started about 4 weeks ago. She is a nurse and did not go right away. She had a pucker diagnosed in the left eye in April 2014 but it didn't bother her as much until recently. VA OD: Dcc20/25 NscJ1 VA OS: Dcc20/32-1 NscJ3-1 She came back 4 years later with a CRAO in the right eye. The pucker in the left eye had spontaneously peeled: She woke up 4 days ago with grayed vision in the right eye. Her peripheral vision came back but she still lost the central vision. She went to the ER where they did not do any testing. She met you and her BP was very high. She went back to the ER and had some labs. She also had a fever of 103. She did not have influenza. She feels like she might be getting bronchitis. She has an appointment for a carotid ultrasound on Monday. She had no focal neurological changes with the initial episode. VA OD: sc1’/200 NccUnable VA OS: sc20/32 NccJ3-1

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Macular Pucker 20/32 with increased distortion for a month464 views00000
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puckeros_nawa1_080614_02.jpg
Macular Pucker 20/32 with increased distortion for a month447 views00000
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puckeros_nawa1_080614_03.jpg
Macular Pucker 20/32 with increased distortion for a month407 views00000
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puckeros_nawa1_080614_04.jpg
Macular Pucker 20/32 with increased distortion for a month430 views00000
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puckerosPAMMOD_nawa2_032818_01.JPG
PAMM post CRAO438 views00000
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PAMM post CRAO439 views00000
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Spontaneously Peeled Macular Pucker 20/20 Vision413 views00000
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puckerosPAMMOD_nawa2_032818_03.JPG
PAMM post CRAO375 views00000
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puckerosPAMMOD_nawa2_032818_05.jpg
PAMM post CRAO456 views00000
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puckerosPAMMOD_nawa2_032818_06.jpg
Spontaneously Peeled Macular Pucker 20/20 Vision447 views00000
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puckerosPAMMOD_nawa2_032818_07.jpg
Spontaneously Peeled Macular Pucker 20/20 Vision370 views00000
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puckerosPAMMOD_nawa2_032818_08.jpg
390 views00000
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puckerosPAMMOD_nawa2_032818_09.jpg
PAMM post CRAO413 views00000
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puckerosPAMMOD_nawa2_032818_10.jpg
Spontaneously Peeled Macular Pucker 20/20 Vision382 views00000
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puckerosPAMMOD_nawa2_032818_11.jpg
Spontaneously Peeled Macular Pucker 20/20 Vision380 views00000
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puckerosPAMMOD_nawa2_032818_12.jpg
Spontaneously Peeled Macular Pucker 20/20391 views00000
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puckerosPAMMOD_nawa2_032818_13.jpg
Spontaneously Peeled Macular Pucker 20/20387 views00000
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pucker-pamm_nawa1__OD_080614_000.jpg
Normal right eye - 4 years later gets CRAO380 views00000
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Normal right eye - 4 years later gets CRAO415 views00000
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64 year old female The patient has a macular pucker and some funky things in the left eye. There is an after image that is getting worse. When she blinks she sees a dark spot that is like a squiggle especially with contrast. She can ignore the left eye. When she is tired the vision in the left eye is dark and smudgy. This started about 4 weeks ago. She is a nurse and did not go right away. She had a pucker diagnosed in the left eye in April 2014 but it didn't bother her as much until recently. VA OD: Dcc20/25 NscJ1 VA OS: Dcc20/32-1 NscJ3-1 She came back 4 years later with a CRAO in the right eye. The pucker in the left eye had spontaneously peeled: She woke up 4 days ago with grayed vision in the right eye. Her peripheral vision came back but she still lost the central vision. She went to the ER where they did not do any testing. She met you and her BP was very high. She went back to the ER and had some labs. She also had a fever of 103. She did not have influenza. She feels like she might be getting bronchitis. She has an appointment for a carotid ultrasound on Monday. She had no focal neurological changes with the initial episode. VA OD: sc1’/200 NccUnable VA OS: sc20/32 NccJ3-1