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75-year-old man was seen in the office on 4/6/2010. He noticed a sudden vision change in the right eye yesterday morning. When he woke up he noticed a cloud in the vision. Previous to this, the vision was good in both eyes. He does have a history in the left eye of endophthalmitis, treated in August of 2009 for which he recovered excellent vision, with a macular pucker. VISUAL ACUITY: Vision OU is 20/20. IOP: 11 OU. The posterior chamber intraocular lens is in good position in both eyes with open capsules. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.0. There is whitening of the superior half of the retina inside the macula. OS: Vertical C/D ratio is 0.0. There is a 2+ epiretinal membrane. OCT SCAN: The OCT scan of the right eye shows thickening of the nerve fiber layer in the macula, as you would expect with an artery occlusion. The left eye has slight irregularities from a macular pucker. PHOTOGRAPHS: Photos confirm clinical findings. FLUORESCEIN ANGIOGRAPHY: FA shows very slow filling of the superotemporal branch retinal arteriole in the right eye. The left eye shows some telangiectasia. The vessels are consistent with the macular pucker. IMPRESSION: 1. BRANCH RETINAL ARTERY OCCLUSION – RIGHT EYE 2. MACULAR PUCKER – LEFT EYE DISCUSSION: I explained to the patient that he has had a branch retinal artery occlusion in the right eye which does count as a minor stroke. I will ask Dr. Neifeld to evaluate him for this. In the meantime, I asked the patient to start taking baby aspirin every day. He does not need to return here unless you or he note further problems.

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Branch Retinal Arterial Occlusion 20/20 Vision - Symptoms for 1 Day749 views75-year-old man was seen in the office on 4/6/2010. He noticed a sudden vision change in the right eye yesterday morning. 20/20 Vision both Eyes
Feb 19, 2011
brao_rivo35.jpg
Branch Retinal Arterial Occlusion 20/20 Vision - Symptoms for 1 Day614 views75-year-old man was seen in the office on 4/6/2010. He noticed a sudden vision change in the right eye yesterday morning. 20/20 Vision both Eyes
Feb 19, 2011
brao_rivo34.jpg
Branch Retinal Arterial Occlusion 20/20 Vision - Symptoms for 1 Day634 views75-year-old man was seen in the office on 4/6/2010. He noticed a sudden vision change in the right eye yesterday morning. 20/20 Vision both Eyes
Feb 19, 2011
brao_rivo32.jpg
Branch Retinal Arterial Occlusion 20/20 Vision - Symptoms for 1 Day666 views75-year-old man was seen in the office on 4/6/2010. He noticed a sudden vision change in the right eye yesterday morning. 20/20 Vision both Eyes
Feb 19, 2011
brao_rivo31.jpg
Branch Retinal Arterial Occlusion 20/20 Vision - Symptoms for 1 Day555 views75-year-old man was seen in the office on 4/6/2010. He noticed a sudden vision change in the right eye yesterday morning. 20/20 Vision both Eyes
Feb 19, 2011
brao_rivo30.jpg
Branch Retinal Arterial Occlusion 20/20 Vision - Symptoms for 1 Day485 views75-year-old man was seen in the office on 4/6/2010. He noticed a sudden vision change in the right eye yesterday morning. 20/20 Vision both Eyes
Feb 19, 2011
brao_rivo29.jpg
Branch Retinal Arterial Occlusion 20/20 Vision - Symptoms for 1 Day466 views75-year-old man was seen in the office on 4/6/2010. He noticed a sudden vision change in the right eye yesterday morning. 20/20 Vision both Eyes
Feb 19, 2011
brao_rivo28.jpg
Branch Retinal Arterial Occlusion 20/20 Vision - Symptoms for 1 Day533 views75-year-old man was seen in the office on 4/6/2010. He noticed a sudden vision change in the right eye yesterday morning. 20/20 Vision both Eyes
Feb 19, 2011
brao_rivo27.jpg
Branch Retinal Arterial Occlusion 20/20 Vision - Symptoms for 1 Day466 views75-year-old man was seen in the office on 4/6/2010. He noticed a sudden vision change in the right eye yesterday morning. 20/20 Vision both Eyes
Feb 19, 2011
brao_rivo26.jpg
Branch Retinal Arterial Occlusion 20/20 Vision - Symptoms for 1 Day495 views75-year-old man was seen in the office on 4/6/2010. He noticed a sudden vision change in the right eye yesterday morning. 20/20 Vision both Eyes
Feb 19, 2011
brao_rivo25.jpg
Branch Retinal Arterial Occlusion 20/20 Vision - Symptoms for 1 Day494 views75-year-old man was seen in the office on 4/6/2010. He noticed a sudden vision change in the right eye yesterday morning. 20/20 Vision both Eyes
Feb 19, 2011
brao_rivo24.jpg
Branch Retinal Arterial Occlusion 20/20 Vision - Symptoms for 1 Day505 views75-year-old man was seen in the office on 4/6/2010. He noticed a sudden vision change in the right eye yesterday morning. 20/20 Vision both Eyes
Feb 19, 2011
brao_rivo23.jpg
Branch Retinal Arterial Occlusion 20/20 Vision - Symptoms for 1 Day488 views75-year-old man was seen in the office on 4/6/2010. He noticed a sudden vision change in the right eye yesterday morning. 20/20 Vision both Eyes
Feb 19, 2011
brao_rivo22.jpg
Branch Retinal Arterial Occlusion 20/20 Vision - Symptoms for 1 Day572 views75-year-old man was seen in the office on 4/6/2010. He noticed a sudden vision change in the right eye yesterday morning. 20/20 Vision both Eyes
Feb 19, 2011
brao_rivo21.jpg
Branch Retinal Arterial Occlusion 20/20 Vision - Symptoms for 1 Day497 views75-year-old man was seen in the office on 4/6/2010. He noticed a sudden vision change in the right eye yesterday morning. 20/20 Vision both Eyes
Feb 19, 2011
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Branch Retinal Arterial Occlusion 20/20 Vision - Symptoms for 1 Day486 views75-year-old man was seen in the office on 4/6/2010. He noticed a sudden vision change in the right eye yesterday morning. 20/20 Vision both Eyes
Feb 19, 2011
brao_rivo19.jpg
Branch Retinal Arterial Occlusion 20/20 Vision - Symptoms for 1 Day505 views75-year-old man was seen in the office on 4/6/2010. He noticed a sudden vision change in the right eye yesterday morning. 20/20 Vision both Eyes
Feb 19, 2011
brao_rivo18.jpg
Branch Retinal Arterial Occlusion 20/20 Vision - Symptoms for 1 Day493 views75-year-old man was seen in the office on 4/6/2010. He noticed a sudden vision change in the right eye yesterday morning. 20/20 Vision both Eyes
Feb 19, 2011
brao_rivo17.jpg
Branch Retinal Arterial Occlusion 20/20 Vision - Symptoms for 1 Day505 views75-year-old man was seen in the office on 4/6/2010. He noticed a sudden vision change in the right eye yesterday morning. 20/20 Vision both Eyes
Feb 19, 2011
brao_rivo16.jpg
Branch Retinal Arterial Occlusion 20/20 Vision - Symptoms for 1 Day489 views75-year-old man was seen in the office on 4/6/2010. He noticed a sudden vision change in the right eye yesterday morning. 20/20 Vision both Eyes
Feb 19, 2011
brao_rivo15.jpg
Branch Retinal Arterial Occlusion 20/20 Vision - Symptoms for 1 Day498 views75-year-old man was seen in the office on 4/6/2010. He noticed a sudden vision change in the right eye yesterday morning. 20/20 Vision both Eyes
Feb 19, 2011
brao_rivo14.jpg
Branch Retinal Arterial Occlusion 20/20 Vision - Symptoms for 1 Day525 viewsFeb 19, 2011
brao_rivo13.jpg
Branch Retinal Arterial Occlusion 20/20 Vision - Symptoms for 1 Day516 views75-year-old man was seen in the office on 4/6/2010. He noticed a sudden vision change in the right eye yesterday morning. 20/20 Vision both Eyes
Feb 19, 2011
brao_rivo12.jpg
Branch Retinal Arterial Occlusion 20/20 Vision - Symptoms for 1 Day503 views75-year-old man was seen in the office on 4/6/2010. He noticed a sudden vision change in the right eye yesterday morning. 20/20 Vision both Eyes
Feb 19, 2011
brao_rivo11.jpg
Branch Retinal Arterial Occlusion 20/20 Vision - Symptoms for 1 Day557 views75-year-old man was seen in the office on 4/6/2010. He noticed a sudden vision change in the right eye yesterday morning. 20/20 Vision both Eyes
Feb 19, 2011
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Branch Retinal Arterial Occlusion 20/20 Vision - Symptoms for 1 Day565 viewsFeb 19, 2011
brao_rivo09.jpg
Branch Retinal Arterial Occlusion 20/20 Vision - Symptoms for 1 Day526 viewsFeb 19, 2011
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Branch Retinal Arterial Occlusion 20/20 Vision - Symptoms for 1 Day532 viewsFeb 19, 2011
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Branch Retinal Arterial Occlusion 20/20 Vision - Symptoms for 1 Day551 viewsFeb 19, 2011
brao_rivo06.jpg
Branch Retinal Arterial Occlusion 20/20 Vision - Symptoms for 1 Day676 viewsFeb 19, 2011
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Branch Retinal Arterial Occlusion 20/20 Vision - Symptoms for 1 Day625 viewsFeb 19, 2011
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Branch Retinal Arterial Occlusion 20/20 Vision - Symptoms for 1 Day685 viewsFeb 19, 2011
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Branch Retinal Arterial Occlusion 20/20 Vision - Symptoms for 1 Day661 viewsFeb 19, 2011
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Branch Retinal Arterial Occlusion 20/20 Vision - Symptoms for 1 Day768 viewsFeb 19, 2011
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Branch Retinal Arterial Occlusion 20/20 Vision - Symptoms for 1 Day877 viewsFeb 19, 2011
 
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75-year-old man was seen in the office on 4/6/2010. He noticed a sudden vision change in the right eye yesterday morning. When he woke up he noticed a cloud in the vision. Previous to this, the vision was good in both eyes. He does have a history in the left eye of endophthalmitis, treated in August of 2009 for which he recovered excellent vision, with a macular pucker. VISUAL ACUITY: Vision OU is 20/20. IOP: 11 OU. The posterior chamber intraocular lens is in good position in both eyes with open capsules. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.0. There is whitening of the superior half of the retina inside the macula. OS: Vertical C/D ratio is 0.0. There is a 2+ epiretinal membrane. OCT SCAN: The OCT scan of the right eye shows thickening of the nerve fiber layer in the macula, as you would expect with an artery occlusion. The left eye has slight irregularities from a macular pucker. PHOTOGRAPHS: Photos confirm clinical findings. FLUORESCEIN ANGIOGRAPHY: FA shows very slow filling of the superotemporal branch retinal arteriole in the right eye. The left eye shows some telangiectasia. The vessels are consistent with the macular pucker. IMPRESSION: 1. BRANCH RETINAL ARTERY OCCLUSION – RIGHT EYE 2. MACULAR PUCKER – LEFT EYE DISCUSSION: I explained to the patient that he has had a branch retinal artery occlusion in the right eye which does count as a minor stroke. I will ask Dr. Neifeld to evaluate him for this. In the meantime, I asked the patient to start taking baby aspirin every day. He does not need to return here unless you or he note further problems.