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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 fundus photographs show peripapillary and inferotemporal pigmentary changes in the right eye. There are some retinal pigment epithelial changes at the left macula and irregularity of the retinal vasculature.

Case 51

Figure 1. Colour fundus photographs show peripapillary and inferotemporal pigmentary changes in the right eye. There are some retinal pigment epithelial changes at the left macula and irregularity of the retinal vasculature.

Author: Amy Pai     Editor: Adrian Fung

A 66-year-old Caucasian lady was referred by her ophthalmologist for a second opinion regarding the cause of a right peri-papillary choroidal neovascular membrane.

Case history

A 66-year-old Caucasian lady presented to her local ophthalmologist complaining of a 2-month history of blurred right vision. She had been diagnosed with a right peri-papillary choroidal neovascular membrane (CNV) a year ago and treated with six intravitreal Bevacizumab injections. They were started at one monthly intervals and she was now being treated on a pro re nata (PRN, “as required”) basis. She was referred for a second opinion when the treating ophthalmologist noticed bilateral vitreous cells. The patient denied any other previous eye issues or operations. She was taking antihypertensive medication but denied smoking or a family history of ocular problems. She wore spectacles for reading.

Visual acuity was 6/18 (pinhole no improvement) in the right eye (OD) and 6/6 in the left eye (OS). Mild nuclear sclerotic cataracts were present in both eyes. There were no anterior chamber cells, flare, or posterior synechiae. Pupil reactions were normal. In both eyes was moderate vitritis, obscuring clear visualization of the fundus, as well as irregularities of the retinal vessels. The optic discs were full but had clear margins. Pigmentary changes were noted at the right peri-papillary region and inferotemporally. and at the left macula (Figure 1).

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