Curbside Consultation in Retina: 49 Clinical Questions

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Sharon Fekrat, MD, FACS joined the Vitreoretinal Surgical Service at the Duke Eye Center in 1998 after completing her ophthalmology and vitreoretinal training at the Wilmer Eye Institute of the Johns Hopkins Medical Institutes. She is now a tenured associate professor of ophthalmology at Duke and the Chief of Ophthalmology at the Durham Veterans Affairs Medical Center. She has co-authored over 60 peer-reviewed articles and over 30 book chapters, is on the editorial board of four professional journals, and has served as site principal investigator for numerous multicenter trials. She is co-editor of Duke Eye Center?s All About Your Eyes book for the lay public. Dr. Fekrat is past president of the North Carolina Society of Eye Physicians and Surgeons.

Table of Contents

• What Are Some Tips to Differentiate Visual Loss From Retinal Disease Versus Cataract?
• What Retinal Findings Would Require Treatment Prior to Cataract or Refractive Surgery?
• What Should I Tell a Myope About the Risk of Retinal Detachment After Cataract or Refractive Surgery?
• How Do I Manage Lattice Degeneration?
• What Retinal Breaks Require Treatment and How Are They Treated?
• What Lesions in the Fellow Eye of a Patient With a Retinal Break or Detachment Require Treatment?
• How Soon Should a Patient With Floaters Be Examined and How Should I Manage a Patient With an Acute Posterior Vitreous Detachment?
• How Long Should I Wait to Perform Cataract Surgery After Treatment of Diabetic Macular Edema or Retinopathy?
• Does Cataract Surgery in an Eye With Dry Age-Related Macular Degeneration Increase the Risk of Developing Choroidal Neovascularization?
• What Should I Do When I See a Patient With a Hollenhorst Plaque?
• What Should I Do When I See a Patient With One or More Cotton-Wool Spots?
• What Should I Do When I See a Patient With One or More Intraretinal Hemorrhages?
• How Do I Work-Up and Manage a Patient With a Vitreous Hemorrhage?
• How Can Optical Coherence Tomography Help Me in My Practice and What Can It Detect?
• With the Rapidly Advancing Technology of Optical Coherence Tomography, Is There Still a Role for Fluorescein Angiography?
• How Important Is a Prompt Diagnosis of Macular Hole?
• When Should I Refer a Patient With an Epiretinal Membrane and What if There Is Associated Cystoid Macular Edema?
• How Do I Differentiate a Macular Hole From a Lamellar Hole, an Epiretinal Membrane With a Pseudohole, Cystoid MacularEdema, and Vitreomacular Traction, and Why Do I Care?
• How Should a Patient With a Gas Bubble Position His or Her Head and What Precautions Should He or She Follow?
• What Is Central Serous Retinopathy and How Do I Treat It?
• What Is the Treatment Paradigm for Postoperative Cystoid Macular Edema?
• Which Patients With Unilateral or Bilateral Dry Age-Related Macular Degeneration Are at Highest Risk for Developing Wet Age-Related Macular Degeneration?
• How Do I Counsel My Patients With Dry Age-Related Macular Degeneration and What About Various Vitamin Supplements?
• What Drugs Can Be Injected Intravitreally and What Ocular and Systemic Complications Should I Look Out For?
• Why Are There so Many Different Triamcinolone Preparations and Which One Should I Use?
• How Do I Monitor for Steroid-Induced Glaucoma After an Intravitreal Injection?
• What Systemic Medications Require Periodic Fundus Evaluation, What Am I Looking For, and What Tests Do I Do?
• How Should I Follow Diabetic Macular Edema and When Does It Require Treatment?
• When Should Eyes With Proliferative Diabetic Retinopathy Receive Panretinal Laser Photocoagulation?
• When Should I Refer a Patient With Diabetic Retinopathy for a Vitrectomy?
• How Do I Follow a Patient Who Has Diabetes and Becomes Pregnant? What Tests Can I Do?
• When Do I Refer a Patient With a Branch Retinal Artery Occlusion or Central Retinal Artery Occlusion, What Is the Work-Up, and What Are the Treatment Options?
• What Do I Do When I See Someone With a Branch Retinal Vein Occlusion and What Are the Treatment Options?
• When Do I Refer a Patient With a Central Retinal Vein Occlusion, What Is the Work-Up, and What Are the Treatment Options?
• If I See a Patient With Shaken Baby Syndrome, What Are the Next Steps?
• What Type of Intraocular Lens Should Be Considered in an Eye With Vitreoretinal Disease?
• When a Posterior Capsular Tear Occurs During Cataract Surgery, What Next?
• When Should a Patient With Dropped Cataract Material or Dislocated Intraocular Lens Be Referred to a Retinal Specialist?
• How Do I Manage a Suprachoroidal Hemorrhage?
• When Should I Suspect Endophthalmitis in My Postoperative Cataract Patient and What Are the Treatment Options?
• How Do I Follow a Patient With a Presumed Choroidal Nevus?
• How Do I Distinguish One Pigmented Lesion From Another?
• How Do I Know if There Is a Retinal Detachment or Tumor When I Am Doing Ultrasonography?
• After a Closed Globe Injury, What Vitreoretinal Findings Should I Expect and When Do I Refer?
• What Should I Tell a Patient With Retinitis Pigmentosa About His or Her Prognosis and Should I Prescribe Vitamin Supplements?
• Which Patients Should I Refer for Electrophysiology Testing and What Might the Test Show?
• How Do I Differentiate All of Those White Dot Syndromes?
• How Do I Work Up a Patient With Intermediate Uveitis or Panuveitis?
• How Do I Differentiate the Infectious Posterior Uveitides And What Are the Current Treatments?