History / Objective Data
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Patient with poor vision and streaks of retinal pigment
J. W. Stokkermans, OD, PhD
A 48 y/o woman presented with a diagnosis of orbital lymphoma affecting the right orbit. She was referred for a baseline exam since she was to receive treatment soon. She reported that her vision had been poor in the right eye for nine years, that she was informed by a previous doctor of a problem with her peripheral vision in the left eye and that it might be retinitis pigmentosa.
Her vision was 20/400, OD and 20/20 OS. The dilated fundus exam OD is shown in Figure 2. The peripheral retinal OD was normal except for a small area of RPE hypertrophy at the ora serrata. The periphery OS revealed 360 degrees of RPE changes that included linear atrophic lesions as shown in Figure 1.
This patient has a problem that precedes her orbital lymphoma. What is your diagnosis? Are there any additional tests you would do? What would be your plan with respect to the retinal disorder?
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Walt Mayo, OD
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Southern Council of Optometry
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