Orbital - Macula Off Retinal Detachment with Vitreous Hemorrhage
Caption
50s M with PMH cataract surgery presented with sudden onset flashing and floaters in his eye, followed by painless vision loss. His visual acuity was limited to light perception only. A still POCUS image is shown here, with an irregular hyperechoic line in the posterior chamber which is attached to the optic disc, representing a retinal detachment. Scattered hyperechoic areas are seen in the posterior chamber anterior to the retina, likely representing vitreous hemorrhage. The presentation with profound painless vision loss and retinal detachment on the medial and lateral aspects of the retina suggests involvement of the macula (“macula off” retinal detachment). This patient was evaluated by ophthalmology in the ED and was taken for operative repair. Dr. Michael Kidon, PGY4 Denver Health Residency in Emergency Medicine