When my cellphone gently buzzed as I sat in a lecture at the recent American Academy of Optometry meeting in New Orleans, I jumped like someone had just stuck me with a needle. I glanced at its retina display and read a cryptic text from my wife: “On ceiling of Voodoo Lounge. Reminds me of my eye last Sunday!”
“Oh my, it’s not even 10 o’clock in the morning. What has she gotten herself into now?” I fretted.
I tapped and pinched the attached picture, enlarging what appeared to be wine-red, dendritic splotches of paint flung against a cream, popcorn ceiling (see image above). It could have been a tinted Rorschach inkblot, blood splatter (that was the intent), or the early makings of a gravity defying, Jackson Pollack painting.
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A snake and then splatter
But my wife was referring to the vitreous in her right eye which started detaching a few days prior, threatening to unravel both her retina and our long-laid trip plans.
She had been driving that day and nearly stomped on the brakes when she saw, in her words, “a snake and then splatter.” That was followed by—you guessed it—“flashes of light.” When I heard her description over the phone, the first differential that popped into my head was a hemorrhagic posterior vitreous detachment (PVD) with a high risk of a retinal tear.
I told her to meet me at my office. The life of an OD’s spouse is a humble one, but it does come with certain perks such as free refractions, bottomless artificial tears, and a dilated fundus exam with extended ophthalmoscopy within 30 minutes of the onset of symptoms.
After combing every square millimeter of her retina with every lens in my arsenal, I was satisfied that there was no discernable blood or retinal break. There was a long string of condensed collagen fibrils hanging like a bridal veil in mid-cavity, and the peripheral retina was flat and smooth. There was no discernible Weiss Ring, however, so I knew the detachment was in evolution and would likely continue for days and perhaps even weeks ahead.