Freaky Eye Friday
DISCLAIMER: picture of an eye below....this one's not bad, though.
i saw a patient today who came in as an emergency. he noticed at 6:00 am this morning that he couldn't see the top part of his vision in his left eye. it happened very suddenly and hasn't gotten better.
we dilated his pupils and looked inside. i saw something that looks kinda like this picture:
this is an example of a Branch Retinal Artery Occlusion (BRAO). let me help you get oriented to the anatomy of the internal eye.
the big yellow circle is the part of the optic nerve that i can see in your eyes. it takes all the information from the eye to the brain. the red crooked lines are blood vessels that take blood to and from the retina (the orange background....you didn't know the inside of your eye was orange, did you?).
in the picture, the 2 arrows that point to the shiny particle in the blood vessel are showing a "plaque" that is blocking the blood from flowing to the retina. since the blood can't reach the retina, it looks pale in that area. the other 2 arrows help you to see how far that reaches.
when i see this condition in practice, it is a wake-up call for the patient. anyone who has a BRAO is at serious risk for having a heart attack or stroke. those are essentially the same things as a BRAO, but they happen in the heart or the brain instead of the eye. my patient today had already undergone a 6-bypass surgery less than one year ago. most likely, this "plaque" came from some blockage that used to be blocking his heart arteries. he's going to be seeing his heart doctor soon to make sure he's not at an immediate risk for another heart attack or a stroke.
the prognosis or outlook for this condition is usually not great. it depends on how long the area is without blood. we weren't able to help it move downstream any today in the office. we recommended increasing his aspirin dosage to help thin the blood and hopefully help this plaque to dislodge.
it's humbling to think that we may have had a role in saving this guy's life because of checking his eyes....
1 comment:
This is a great post. You need to open a practice in Kimberly, Morris, or Gardendale. There is a little shopping center that is being anchored by a grocery store going up in Kimberly. Hint Hint. I know of two patients you would have right off the bat. :)
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