Differential Diagnosis - Pacific University

5/29/2012
Increase in myopia*
Improvement in hyperopia
Vision changes more common after 20
treatments and in patients >40 years old
This is usually temporary and in the
majority of patients, vision returns to its
pre-treatment level about six weeks after
the cessation of therapy
CC: Decreased vision at distance OU, that
occurred suddenly after receiving O2 treatments
LEE: ~ 08/11 with Dr. X (a non-VA provider);
07/13/11 CVE at the Portland VAMC
Current Ocular Medications: Prednisone TID OS
prescribed initially by Dr. X for an “abrasion”
and a “viral infection” that he has been using
intermittently since ~08/11 (renewed by his PCP)
– had been off for 1 month and was about to
restart
Personal OHx: corneal abrasion OS with a
viral infection dx ~8/11
Family OHx: Unremarkable
Pertinent Medical Conditions: DM II,
COPD, Vitamin D deficiency, prostate
cancer
Autorefractor:
• RE:-1.25-0.75x091 LE:-1.75-1.00x013
Current Spec Rx: Bifocals
• RE:-0.50DS 20/60 PH:20/40
• LE:-0.25-0.75x033 20/150 PH:20/80
• ADD:+2.50
Pupils: PERRL (-)APD OU
EOMS:FROM OU
CF:FTFC OU
SLE:
• L/L: BE: flakes, lower lid laxity w/ mild proptosis
• Conj: BE: Ping N&T LE:1+ diffuse injection temp
• Cornea:BE: arcus 360 w/ krukenberg spindles
• LE: central areas of white patchy stromal haze
• Sectoral deep stromal NV from ~3:00-5:00
• Central folds and SEI, bullae superior cornea
• (+)staining over the neo with stromal filling
• A/C: Deep and Quiet OU
• Iris: Normal w/o NVI OU
• Tonomtery by Applanation: 15/16 @ 15:48
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