#caseoftheweek

Keratoconus or Epithelial Basement Dystrophy? #caseoftheweek Epithelial thickness mapping (ETM) with Widefield OCT can help to differentiate corneal thinning disorders with focal corneal bulging (#keratoconus) vs. epithelial thickening disorders (#ebmd). #swipeleft⬅️ to see normal ETM followed by ETM in this patient showing inferior epithelial thickening overlying inferior steepening on topography. Patient has EBMD. PRK is best for this patient. Patient co-managed with an amazing eye doctor in San Francisco @hyper_optics, Dr. Diana Pham 👁No need for crosslinking. #pacificvisioninstitute #prk #sanfrancisco #besafe #optometrist #ophthalmologist #eyedoctor #eyecare #correctdiagnosis #besteyedoctor (at Pacific Vision Institute) https://www.instagram.com/p/CCEPaK0h_nI/?igshid=18atd76twg3pr

#caseoftheweek 52 y.o. presents with -4D myopic shift several decades after #lasik. Careful lens exam holds the key to what can be done to bring patient back to #emmetropia. There may be just 1+ to 2+ NS, but retro illumination is critical to reveal subtle findings - like these vacuoles, for example. Myopic eyes are more likely to form cataracts, regardless of whether they had LASIK. The best treatment for this patient is #cataractsurgery rather than laser enhancement. Be on the look out for subtle signs of cataract #lensvacuoles and #oildropletcataract in middle-aged and older myopes with myopic shift #pacificvisioninstitute #lasiksanfrancisco #cataract #cataracts #photooftheday #eyes #ophthalmology #ophthalmologyresident #optometry #optometryschool #optometrystudents #medstudentslife (at Pacific Vision Institute) https://www.instagram.com/p/B4ktlPzBH78/?igshid=1odx2qfyhjstl

#caseoftheweek subtle EBMD is best seen with retro illumination 👀to the left of the slit beam. #prk is better than #lasik for these patients. #pacificvisioninstitute #drellafaktorovich #cornealsurgery #ophthalmologist #optometrist #optician #photooftheday #sanfrancisco #eyedoctor #lasiksanfrancisco (at Pacific Vision Institute) https://www.instagram.com/p/B3cjyiuh3Ib/?igshid=fqkd5wwtm4fr

#caseoftheweek 👁 An RK (Radial Keratotomy) patient will typically have hyperopic astigmatism. It may be mild and not require correction, or it could be enough to warrant glasses, contacts, or vision correction surgery. #prk is better that #lasik for these patients. #pacificvisioninstitute #laservisioncorrection #eyesurgeon #lasereyesurgery #sanfrancisco #PVI #medstudent #optometrists #ophthalmologists #photooftheday (at Pacific Vision Institute) https://www.instagram.com/p/B3Kh5u4BLV2/?igshid=tblzuksqlb4m

#caseoftheweek 👁Central Heterochromia 👀No problem with iris registration for great CONTOURA Vision LASIK result #pacificvisioninstitute #lasik#lasiksanfrancisco #eyes #lovewhatyoudo #photooftheday #sanfrancisco (at Pacific Vision Institute) https://www.instagram.com/p/B245cDwBrGI/?igshid=p1j41e28sj5z

#caseoftheweek 👁Faint vertical fingerprint lines can be hard to see in patients with light irides. They are a sign of Epithelial Basement Membrane Dystrophy. #prk is better than #lasik for these patients #pacificvisioninstitute #cornealsurgery #eyesurgery #sanfrancisco #cornea #photooftheday (at Pacific Vision Institute) https://www.instagram.com/p/B2mjXLxhfEP/?igshid=saptj4dcd82r

#caseoftheweek 👁 28 year old overweight -7D myope presents for LASIK evaluation. Mild bilateral disc edema detected. Patient referred for neuro-ophthalmic evaluation. Diagnosed with pseudotumor cerebri. Weight loss program initiated. Chronic mild disc edema in patients with myopic disc tilt may be difficult to detect but should be looked for especially in patients with risk factors. #pacificvisioninstitute #ophthalmologist #optometrist #opticians #medstudent #ophthalmology #lasikscreening #sanfrancisco (at Pacific Vision Institute) https://www.instagram.com/p/B2UgfHeh6pJ/?igshid=cgh7atokrg7j

#caseoftheweek 👁Bilaterally symmetric areas of negative staining in the otherwise clear corneas are a sure sign of Epithelial Basement Membrane Dystrophy (EBMD). Right eye - negative staining at 5 o’clock. Left eye - negative staining at 7 o’clock. Wavefront-optimized PRK is the best choice for patients with EBMD. Wavefront-guided or topography-guided will attempt to clear epithelial bumps that will be gone anyway when epi is removed. #pacificvisioninstitute #prk #lasik #optometrist #ophthalmologist #optician #cornealsurgeon #bestchoice #eyes #sanfrancisco #medstudent (at Pacific Vision Institute) https://www.instagram.com/p/B2CQPM4BhaC/?igshid=xruy3d9egl19