History of Present Illness
It is the beginning of the school year for first graders. An eye examination is required, and a 6-year-old girl has best corrected visual acuity (VA) 20/20 right eye (OD) and 20/80 left eye (OS). She is otherwise is in good health. Her mother has noticed that she does not see objects or people coming from either side. She has no history of trauma to either eye. However, she likes to play in the sandbox in a park near her house.
| OD | OS | |
|---|---|---|
| Visual acuity | 20/20 | 20/80 |
| Intraocular pressure (IOP) (mm Hg) | 9 | 8 |
| Sclera/conjunctiva | Clear. No injection | Clear. No injection |
| Cornea | Clear | Clear |
| Anterior chamber (AC) | No cell or flare | No cell or flare |
| Iris | Within normal limits (WNL) – no posterior synechiae | WNL – no posterior synechiae |
| Lens | Clear | Clear |
| Vitreous cavity | Clear | No vitreous cells |
| Retina/optic nerve | Normal optic nerve, posterior and peripheral retina | Tractional band extending from the optic nerve to the center of the macula with a localized tractional retinal detachment in the posterior pole ( Fig. 51.1 ) |
Questions to Ask
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Has your daughter ever complained of not seeing well in her OS?
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Has she ever had redness, pain, or light sensitivity in her OS?
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Do you have any pets at home?
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Does she play in a sandbox where dogs also are occasionally seen?
The patient has not complained of not seeing well in her OS, nor has she had redness, pain, or light sensitivity in either eye. The family has two golden retrievers at home who are now 4 and 5 years old. The family frequently goes to the local public park, which has a sandbox, and many dogs are roaming around the park with their owners.
