An 11-year-old with some blur in his left eye presents for his first eye exam.
An 11-year-old Caucasian male reported to the office for a routine eye examination. He explained that his doctor wanted him to get his first eye exam and that recently—within the last month—he noticed some blur in his left eye.
His systemic and ocular histories were unremarkable and he denied allergies of any kind.
His best-corrected entering visual acuities were 20/20 OD and 20/25 OS at distance and near. His external examination was normal with no evidence of afferent pupillary defect.
The biomicroscopic examination of the anterior segment was normal in every way. IOP by Goldmann applanation tonometry measured 15mm Hg OU.
The pertinent fundus finding are demonstrated in the photographs.
Additional studies included examination photodocumentation of the lesion, Amsler grid testing to understand the effect on function as well as form use in home monitoring an optical coherence tomograph (OCT) to uncover the vitreoretinal etiology and laser interferometry to understand the maximum potential correctable acuity.
Do these fundus photographs provide any explanation for our patient’s blurred vision? Click images to enlarge.
The patient was referred to retinology. They agreed with our diagnosis and in the absence of substantuial lost function, decided to monitor the case with dilated evaluation and serial OCT biannually.
Dr. Gurwood thanks Drs. Gardner, Brown and Meagher for their contributions to this case.
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