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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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Colour photograph demonstrating a well demarcated circular area of left macular elevation together with retinal haemorrhages.

Case 31

Figure 1. Colour photograph demonstrating a well demarcated circular area of left macular elevation together with retinal haemorrhages.

Author: Michael Chilov     Editor: Adrian Fung

A 20-year-old man was referred with a central scotoma in his left eye.

Case history

A 22-year-old cook was referred by his optometrist complaining of a two-day history of worsening vision in his left eye. He had no previous ophthalmic history and had not seen an optometrist for many years. His past medical history included acne but he was not on any regular treatment. He was a “recreational” smoker. He had not used any corticosteroid medications. He denied any recreational drug use.

Visual acuity was 6/5 in the right eye (OD) and 6/18- in the left eye (OS). There was no relative afferent pupil defect (RAPD). Examination of the left fundus revealed a well demarcated circular area of elevated retina (serous retinal detachment) involving the macula (Figure 1). There were a number of small intraretinal haemorrhages within the area of elevated retina. There was no intraocular inflammation visible, with no cells in the vitreous or anterior chamber. The retinal vasculature was otherwise normal as was the peripheral retina. The right fundus was normal. Intraocular pressures were 14mmHg (OD) and 14 mmHg (OS).

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