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Here you’ll find interesting cases of eye conditions along with news and developments in the ophthalmology world.

Cases are presented as an initial image with history and examination. Health practitioners are encouraged to deduce the condition, before further investigations, diagnosis and management are presented.

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Right fundus photograph showing a haemorrhage at the right macula.

Case 19

Figure 1. Right fundus photograph showing a haemorrhage at the right macula.

Author: Michael Chilov     Editor: Adrian Fung

A 22-year-old man presented with a “blob” in the centre of his right vision.

Case history

A 22-year-old male electrical engineering student was referred by his optometrist after complaining of the sudden development of a “blob” in his right central vision.

The patient was a mild myope. At the previous examination with his optometrist his glasses had been strengthened to -1.25DS (right eye) and -1.00/ -0.50 x 88° (left eye). No other abnormality had been noted at that assessment. He had a past medical history of mild asthma and infrequently used a Ventolin® (salbutamol) puffer. He was not taking any anticoagulants or herbal medication.

Visual acuity was 6/18 in the right eye (OD) and 6/6+ in the left eye (OS). Fundus examination demonstrated a haemorrhage at the right macula (Figure 1). The haemorrhage was inner/pre-retinal, well demarcated and had an elevated appearance with a smooth dome shaped surface. There were no other haemorrhages in either eye. The retinal vasculature was otherwise normal with no arteriovenous nipping or reflex changes. There were no microaneurysms and no other vascular lesions noted. There was no posterior vitreous detachment visible in either eye. Optic nerves were healthy and intraocular pressures were 17mmHg in both eyes.

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