Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargement
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33-year-old woman who I saw in the office on December 10, 2008. One week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. She had an MRI done in the emergency room, which was fine and comes in for an evaluation because of the vision change in the right eye.
VISUAL ACUITY: OD 20/20, OS 20/20. IOP: OD 11, OS 12.
SLIT EXAMINATION: The lens is clear in both eyes.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.0. There is 1+ vitreous cells. There are a few subtle white spots in the retina, predominately clustered around the nerve.
OS: Vertical C/D ration is 0.0. There is no posterior vitreous separation. Photos confirm clinical findings.
FLUORESCEIN ANGIOGRAM: The fluorescein angiogram shows a blush of fluorescein around the optic nerve in the right eye, which looks to be deep, without leakage. The optic nerve does not leak. There is no retinovasculitis. The left eye looked angiographically normal. I obtained a visual field test, which shows a normal visual field in both eyes.
IMPRESSION:
1. LOW-GRADE MULTIPLE EVANESCENT AND WHITE DOT SYNDROME – RIGHT EYE
DISCUSSION: I explained to the patient that findings are consistent with multiple evanescent and white dot syndrome. She looks to have a very mild case of it and I suspect this will reverse with time. I did ask her to return for a check in about six weeks or sooner should she notice a problem and see you regularly.
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvista 862 veces33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votos)
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvista 988 veces33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votos)
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvista 866 veces33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votos)
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvista 817 veces33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votos)
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvista 732 veces33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votos)
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvista 705 veces33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votos)
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvista 673 veces33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votos)
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvista 676 veces33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votos)
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvista 702 veces33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votos)
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvista 635 veces33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votos)
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvista 561 veces33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votos)
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvista 510 veces33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votos)
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvista 524 veces33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votos)
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvista 605 veces33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votos)
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvista 579 veces33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votos)
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvista 609 veces33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votos)
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvista 583 veces33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votos)
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvista 768 veces33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votos)
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvista 687 veces33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votos)
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Multiple Evanescent White Dot Syndrome - Acute Idiopathic Blind Spot Enlargementvista 717 veces33-year-old woman one week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. OD 20/20, OS 20/20
(0 votos)
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33-year-old woman who I saw in the office on December 10, 2008. One week ago she awoke and saw a red spots flashing out of her right eye. She notices them to the right side, which is the temporal visual field out of the right eye, then they changed to bursts of white lights without colors and then she notices straight ahead a couple spots. She has headaches in the back of her head. She had an MRI done in the emergency room, which was fine and comes in for an evaluation because of the vision change in the right eye.
VISUAL ACUITY: OD 20/20, OS 20/20. IOP: OD 11, OS 12.
SLIT EXAMINATION: The lens is clear in both eyes.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.0. There is 1+ vitreous cells. There are a few subtle white spots in the retina, predominately clustered around the nerve.
OS: Vertical C/D ration is 0.0. There is no posterior vitreous separation. Photos confirm clinical findings.
FLUORESCEIN ANGIOGRAM: The fluorescein angiogram shows a blush of fluorescein around the optic nerve in the right eye, which looks to be deep, without leakage. The optic nerve does not leak. There is no retinovasculitis. The left eye looked angiographically normal. I obtained a visual field test, which shows a normal visual field in both eyes.
IMPRESSION:
1. LOW-GRADE MULTIPLE EVANESCENT AND WHITE DOT SYNDROME – RIGHT EYE
DISCUSSION: I explained to the patient that findings are consistent with multiple evanescent and white dot syndrome. She looks to have a very mild case of it and I suspect this will reverse with time. I did ask her to return for a check in about six weeks or sooner should she notice a problem and see you regularly.
