History of Present Illness
A 15-year-old healthy boy with no past medical history presents for the first time to the eye clinic complaining of blurred vision in his left eye (OS). He noticed some change about a month ago and now notices a significant difference between the two eyes, especially when he plays football. He also complains of floating spots in the OS ( Figs. 21.1 and 21.2 ).
Exam
| OD | OS | |
|---|---|---|
| Visual acuity | 20/20 | 20/40− |
| Intraocular pressure (IOP) | 15 | 14 |
| Sclera/conjunctiva | White and quiet | White and quiet |
| Cornea | Clear | Clear |
| AC | Deep and quiet | {1/2}+ white cells, 1+ flare |
| Iris | Unremarkable | Unremarkable |
| Lens | Clear | Clear |
| Anterior vitreous | Clear | 1+ cells |
(A) Color fundus photograph of the left eye shows hazy media consistent with vitritis and multiple snowballs. (B) Color fundus photograph of the left eye temporal to the macula shows vascular sheathing.
(A) Optical coherence tomography (OCT) of the right eye shows normal macular structure and trace posterior vitreous cell. (B) OCT of the left eye shows normal macular structure without cystoid macular edema but with degraded image quality, increased hyperreflectivity of the vitreous, and posterior vitreous cells consistent with vitreal inflammation.
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