Case #76: When and how to treat vitreous opacities

 Eidon fundus photos bypass the vitreous opacities. This gives the advantage of allowing a full assessment of the retina with limited to no interference from the opacities.

 Optos fundus photo demonstrates the obstructive nature of this patient’s current vitreous opacity. These vitreous opacities are dense and mobile causing large fluctuations in quality of vision.

Magnified fundus photo taken with Optos one day after symptoms started: Reveals assumed anterior vitreous detachment OS. Reported by the patient as a circle/oval and was the size of the full moon when looking at the night sky. It disappeared within a day. Unfortunately, little information has been published regarding

Fundus photos: Depending on the imaging device used, vitreous floaters can be imaged on fundus photography. EIDON and Zeiss Clarus eliminate floaters while Optos does not. This means Optos may have an advantage of helping ophthalmic clinicians understand the visual impact of the vitreous opacities as compared to the other

Ultrasound:  Vitreous opacities and PVD imaged with B-scan ultrasound OS consistent with dilated exam.

Diagnosing Vitreous Opacities5: Outside of a standard exam, recent articles published in Healio recommend the following additional tests to assess the impact of the vitreous opacities and determine the best potential treatment options.OCTUltrasoundFundus photosVisual function questionnaire score

 Eidon fundus photo reveals s/p barrier laser to treat retinal tears in the superior nasal and inferior nasal retina OS.

Clinical Findings: VA 20/20 OD, 20/25+ OSIOP 10/10 @12:17 pmAnterior seg unremarkableVitreous: Assumed anterior vitreous detachment OS, vitreous syneresis OU, PVD OUPosterior seg:OD: unremarkableOS: 2 retinal tears superiorly with barrier laser and 2 retinal tears inferiorly with barrier laser.MARS Contrast sensitivity: Normal CS OD, moderate CS loss OS

Case Report: Note: All images throughout this case report are from the patient’s left eye over the span of 2 decades.Chief complaint: 69 yo W F presents with longstanding floaters worse OS than OD which are  impacting vision and are difficult to adapt to due to their excessive movement. Pt

Introduction: Vitreous floaters are a common visual phenomenon experienced by many individuals at some point throughout their lives. In a review of 603 smartphone users, 76% (n=458) indicated that they notice floaters, 33% of those indicated that their floaters caused noticeable visual impairment.1 The primary etiologies of vitreous opacities are