Clinical Crossroads Section Editor: Margaret A. Winker, MD, Deputy Editor.
Author Affiliation: Dr Arroyo is Assistant Professor of Ophthalmology, Harvard Medical School, and Retina Service Director, Division of Ophthalmology, Beth Israel Deaconess Medical Center, Boston, Mass.
DR SHIP: Dr G is a 76-year-old semiretired surgeon. He is married, lives in the New York metropolitan area, and has indemnity insurance and Medicare.
Dr G's ophthalmologic history was notable for mild myopia, bilateral drusen, and an episode of self-limited central serous retinopathy in the left eye at the age of 38 years. Approximately 3 years ago, he noted subtle vision changes. These symptoms progressed over a 2-month period and he saw his general ophthalmologist. He was found to have mild nuclear sclerotic cataracts (right greater than left), corrected visual acuity of 20/40 in the right eye and 20/25 in the left eye, and an exudative retinal detachment in the right eye. He was referred to a retinal specialist that day.
Arroyo JG. A 76-Year-Old Man With Macular Degeneration. JAMA. 2006;295(20):2394-2406. doi:10.1001/jama.295.20.2394