MAR 2014

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

Issue link: https://digital.eyeworld.org/i/276058

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Page 142 of 210

E W RESIDENTS 140 March 2014 by Matthew W. Manry, MD, resident, and Shahzad I. Mian, MD, residency program director, Kellogg Eye Center, University of Michigan It's all in the history M any ophthalmologists take advantage of practicing near an academic ophthal- mology program to attend weekly grand rounds. One mainstay of grand rounds is the resident case presentation that serves as a springboard for discussion of d iagnosis and management. Because the majority of us can't take advantage of these sessions, I thought it would be informative for EyeWorld to regularly feature anterior segment grand rounds case presentations from leading a cademic departments. Building on the popularity and quality of "EyeWorld journal club," we will invite a different academic program every month to pres- ent a grand rounds case to our readers. Our first case is presented courtesy of the Department of Ophthalmology at the University of Michigan. –David F. Chang, MD, c hief medical editor History of present illness A 22-year-old Caucasian woman presents to the emergency room after seeing her local optometrist for bilateral eye pain. She had woken up that morning with a headache and noticed that both of her eyes looked r ed and puffy. As the day went on she noted worsening swelling and a deep, sharp pain in both eyes. She also described blurred vision and mild photosensitivity progressing throughout the day. She went to her optometrist who referred her emer- gently for elevated eye pressures of 47 mm Hg. She has a history of photorefrac- tive keratectomy (PRK) one year ago and bipolar I disorder. There was no family history of glaucoma, but her father was blind in one eye from an unknown cause. Examination The patient's best corrected visual acuity was 20/80 and 20/60 in the right and left eyes, respectively. Pupils were minimally but equally reactive without an afferent pupil- lary defect. Motility, alignment, confrontational visual fields and color vision testing were all normal. Hertel exophthalmometry was 19 mm in both eyes. Slit lamp examination was notable for bilateral mild upper and lower lid edema and significant chemosis. There was no notable con- junctival injection. The corneas were clear, and both eyes had very narrow anterior chambers by Van Herick examination. Fundoscopic retinal examination was normal in both eyes with normal appearing optic nerves without pallor or edema. An undilated gonioscopy exam in both eyes demonstrated only anterior trabecular meshwork structures at the angle in both eyes. There was no neovascularization or peripheral anterior synechiae. Register now: www.EyeWorld.org/meetings/bausch B O S T O N 2 014 Sponsored by: Save the Date Sunday, April 27, 2014 Managing Complex Cataracts – Approaches to Handling Challenging Cases with Innovative Techniques and Technologies Westin Boston Waterfront Hotel – Grand Ballroom (concourse level) 425 Summer Street – adjacent to the Boston Convention and Exhibition Center (Skybridge located on level 2 of convention center) 4:45 – 5:15 PM Registration and Reception 5:15 – 6:30 PM Program Program Chair R. Bruce Wallace, MD Faculty Johnny L. Gayton, MD Douglas A. Katsev, MD Robert J. Weinstock, MD Jeffrey Whitman, MD SUR/STL/14/0005 A cademic grand rounds Shahzad I. Mian, MD, residency program director, Kellogg Eye Center, University of Michigan 138-143 Residents_EW March 2014-DL2_Layout 1 3/6/14 4:16 PM Page 140

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