More eyes!

It has been another busy week in eye clinic. Dr. Nick Patel and his wife, Dr. Grace Patel are here helping out with clinic and surgery. Dr. Patel did his Retina Fellowship at Iowa (where I trained), so we are having fun talking about the eye department at Iowa.  His wife, Grace, just finished her training in Pediatric Ophthalmology, so it is awesome to have them here.

I am becoming much more used to the clinics here and the "unusual" is becoming the norm for me. Clinical situations that used to surprise me, such as unusual diagnoses, have become routine.

Here are some photos for the week:



Scleritis

Giant papillae on superior tarsal conjunctiva. This is typical in vernal keratoconjunctivits, but it was unilateral. We are starting this patient on steroids and will see him back in two weeks. If improved, we will give a subtarsal injection of dexamethasone.

Subconjunctival hemorrhage in right eye. This is not all that exciting, but I post it because it occurred during  a soccer game. The kids LOVE their soccer!

60 year-old lady with bilateral scleral thinning. You can see the uvea (dark areas) showing through. She has evidence of old ocular inflammation. (See her anterior segment exam below). Etiology is unknown.

Poor dilation (lady above). There is fibrin around the pupillary margin. She also had areas of pannus. She did not have any current intraocular inflammation. There was a very poor view to the fundus. Her vision was 2/60 (equivalent of 20/600) in this eye, so we will attempt small incision cataract surgery tomorrow. She did not have an RAPD in this eye and her pressure was fine. It is possible she will not see much better in this eye after cataract extraction, but her other eye doesn't see well either and it is her only hope.
 

The patient from last week on whom Angie and I did a bilateral pterygium excision with conjunctival autograft. He was so happy. His eyes looked great and his vision had improved significantly in both eyes! Great work, Dr. McAllister!