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JAMA Ophthalmology Clinical Challenge
October 2017

Retinal Whitening After Uncomplicated Cataract Surgery

Author Affiliations
  • 1Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston
JAMA Ophthalmol. 2017;135(10):1117-1118. doi:10.1001/jamaophthalmol.2017.1445

A woman in her 60s presented 1 week after undergoing cataract surgery in the right eye complaining of persistent blurry vision. Her ocular history was notable for a previous uncomplicated cataract surgery in the left eye that had a good visual outcome. On postoperative day 1, her visual acuity was 20/60 OD, attributed to mild corneal edema, with an intraocular pressure of 18 mm Hg. A dilated fundus examination was not performed. At postoperative week 1, the best-corrected visual acuity was 20/50 OD, her intraocular pressure was 17 mm Hg, and there was no afferent pupillary defect. The cornea was clear and there were trace anterior chamber cells. A dilated examination revealed multiple spots of retinal whitening with tiny intraretinal hemorrhages concentrated in the posterior pole (Figure, A). The patient was referred urgently for consultation by a retina specialist. Optical coherence tomography revealed intraretinal cystoid abnormalities in the macula and hyperreflective patches in the nerve fiber layer and inner nuclear layer (Figure, B).

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