This week’s VOTW is thanks to Drs. Jennie Xu and Leily Naraghi!
HPI: 56 yo male with PMH of HTN presenting for sudden near complete vision loss in his right eye since 1pm yesterday.
Review of POCUS eye anatomy
Image/Video 1: Retinal detachment - you can differentiate this from vitreous hemorrhage because retinal detachments are typically thicker and are tethered to the optic nerve posteriorly.
Image/Video 2: “Washing machine sign” is concerning for vitreous hemorrhage
There are ways to figure out if a retinal detachment is “mac-on” or “mac-off”. The macula is temporal to the optic nerve in each eye. “Mac-on” retinal detachments are true ophthalmological emergencies and need to go to the OR emergently to have the retinal reattached and save their vision. It's hard to be sure though so if you see a retinal detachment, consult ophthalmology.
Conclusion: Patient was transferred to SUNY Downstate for ophthalmological repair of partial retinal detachment.