Acute Bilateral Central Serous Retinopathy - Bullous Serous Retinal Detachment
|
|
49-year-old man was seen in the office on August 7, 2008. He has had decreasing vision in the left eye. It started about a week ago. He was having trouble focusing and then he noticed at a ball game his vision was worse and then this weekend he can hardly play golf. His right eye has been tired. He does work with table saws and things like that and it has been extremely difficult trying to work with only vision in one eye. He takes Atenolol and Zocor. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400. IOP: OD 12, OS 13. The lenses are clear in both eyes.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.4. There is no posterior vitreous separation. There is a serous retinal detachment inferior to the macula.
OS: Vertical C/D ratio is 0.3. There is no posterior vitreous separation. There is a serous retinal detachment in the macula.
OCT SCAN: I appreciate you sending the OCT scans, which do show a serous macular detachment inferior to the fovea in the right eye and centrally in the left eye.
Photos confirm clinical findings.
FLUORESCEIN ANGIOGRAM: FA does show one hot spot in the right eye and two hot spots in the left eye with leakage typical for central serous retinopathy.
His blood pressure was 140/85.
IMPRESSION:
1. IDIOPATHIC CENTRAL SEROUS RETINOPATHY – BOTH EYES
DISCUSSION: I explained to the patient he does have central serous retinopathy and 95% of people with this do spontaneously improve, although it can take up to six months. I asked him to return for a check in six to eight weeks, sooner should he notice any problems.
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute 889 views49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute 746 views49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute 716 views49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute 712 views49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute 883 views49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute 889 views49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute 790 views49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute 665 views49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute 782 views49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute 726 views49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute 585 views49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute 648 views49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute 587 views49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute 639 views49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute 586 views49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute 548 views49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute 522 views49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute 491 views49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute 516 views49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute 515 views49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute 484 views49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute 521 views49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute 534 views49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute 527 views49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute 539 views49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute 555 views49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute 510 views49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute 505 views49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute 680 views49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(1 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute 489 views49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute 452 views49-year-old man decreasing vision in the left eye for one week. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute 4 months later VA 20/40 OU591 viewsNo treatment and fluid under fovea in left eye is competely absorbed at 4 months.
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute 4 months later VA 20/40 OU487 viewsNo treatment and fluid under fovea in left eye is competely absorbed at 4 months.
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute 4 months later VA 20/40 OU625 viewsNo treatment and fluid under fovea in left eye is competely absorbed at 4 months.
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute 4 months later VA 20/40 OU663 viewsNo treatment and fluid under fovea in left eye is competely absorbed at 4 months.
(0 votes)
|
|
Idiopathic Central Serous Retinopathy - Bilateral - Acute - 4 months later VA 20/40 OU759 viewsNo treatment and fluid under fovea in left eye is competely absorbed at 4 months.
(0 votes)
|
|
|
|
49-year-old man was seen in the office on August 7, 2008. He has had decreasing vision in the left eye. It started about a week ago. He was having trouble focusing and then he noticed at a ball game his vision was worse and then this weekend he can hardly play golf. His right eye has been tired. He does work with table saws and things like that and it has been extremely difficult trying to work with only vision in one eye. He takes Atenolol and Zocor. He is not taking any steroid or steroid-related products. His blood pressure as far as he knows is under control.
VISUAL ACUITY: OD 20/30, OS 20/400. IOP: OD 12, OS 13. The lenses are clear in both eyes.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.4. There is no posterior vitreous separation. There is a serous retinal detachment inferior to the macula.
OS: Vertical C/D ratio is 0.3. There is no posterior vitreous separation. There is a serous retinal detachment in the macula.
OCT SCAN: I appreciate you sending the OCT scans, which do show a serous macular detachment inferior to the fovea in the right eye and centrally in the left eye.
Photos confirm clinical findings.
FLUORESCEIN ANGIOGRAM: FA does show one hot spot in the right eye and two hot spots in the left eye with leakage typical for central serous retinopathy.
His blood pressure was 140/85.
IMPRESSION:
1. IDIOPATHIC CENTRAL SEROUS RETINOPATHY – BOTH EYES
DISCUSSION: I explained to the patient he does have central serous retinopathy and 95% of people with this do spontaneously improve, although it can take up to six months. I asked him to return for a check in six to eight weeks, sooner should he notice any problems.
