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Understanding Retinoschisis and Its Potential for Retinal Detachment

A 74-year-old male patient with a history of hypertension, hyperlipidemia, and atrial fibrillation presented with acute vision issues in his left eye. The diagnosis revealed retinoschisis in both eyes, with a vitreous hemorrhage and inner-retinal hole in the left eye. The case underscores the need for physicians to differentiate retinoschisis from other conditions and to monitor for potential complications like retinal detachment.

Key Points:

• The patient presented with 20/40 OD and 20/150 OS acuity, and IOP was 15mm Hg OD and 11mm Hg OS.
• Diagnosis confirmed retinoschisis in both eyes and a vitreous hemorrhage in the left eye.
• Retinoschisis is most commonly bilateral and found in middle-aged individuals with an incidence of 1% to 3.7%.
• The condition can remain stable without intervention but may lead to retinal detachment in certain cases.

Additional Points:

• Retinoschisis can be asymptomatic and often remains stable without treatment.
• Outer retinal breaks are more common than inner retinal breaks in retinoschisis cases.
• Close observation was elected for the patient, with serial dilated fundus exams and B-scans.

Conclusion:

• Optometrists should be vigilant in diagnosing retinoschisis, differentiating it from other conditions, and monitoring for potential complications such as retinal detachment.

Up to 7% of patients over the age of 40 may experience retinoschisis, a condition that can remain stable but has the potential to lead to retinal detachment.

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