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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 10777
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I had an eye exam today as I am having a PVD in my left eye.

Resolved Question:

I had an eye exam today as I am having a PVD in my left eye. The opthomologist mentioned peripheral papillary atrophy around the optic nerve in the right eye that has a PVD that is apparently complete as it initiated 5 months ago. I asked if it were progressive and he really did not give me any information other than to say it was not. I asked if peripheral papillary atrophy was and age related problem and he had no comment other than to say another doctor in the practice noted it in 2009. I am myopic and 57 years old. Is this of significance and does it warrant further evaluation?
Submitted: 5 years ago.
Category: Eye
Expert:  Dr. Rick replied 5 years ago.

Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick :

Are you available to chat?

Customer :

Yes. Thanks.

Dr. Rick :

Peripapillary atrophy is nothing to be worried about. It is a very common finding, especially in people who are myopic. It is not, in the vast majority of cases, progressive.

Customer :

Does it predispose you to glaucoma, macular degeneration or other retinal disorders? I do have a positive family history of macular degeneration (aunt). Is it common to see in one eye and not the other?

Dr. Rick :

Go to fullsize image
Full Size Image

Dr. Rick :

let me first tell you about the picture...

Dr. Rick :

the lines are the blood vessels in your eye. The pink doughnut is the optic nerve and teh white crescent, between the lines is an area of peripapillary atrophy

Customer :

Are you referring to the area demarcated by the white lines or black lines? I see the lighter circular area of course, but am not sure I see the area of peripapillary atrophy.

Dr. Rick :

It does not predispose you to glaucoma or any other retina/eye problems. It can be more pronounced in one eye then the other and, like your ophthalmologist said, his partner made a note of it over a decade ago....and I'd bet it hasn't changed since then. Retina is what I do all day long and I promise you that you have nothing to worry about when it comes to this finding :o)

Dr. Rick :

the white lines mostly. The black lines are a rim of retina tissue

Customer :

It was noted in 2009 - only a year or so ago.

Dr. Rick :

oops.....math never was my strongest subject

Customer :

So the optic nerve is the central lighter area and the atrophy is the similarly colored area of small dimension on the periphery?

Dr. Rick :

My eyes saw 2009 and my brain thought1999. It must be getting past my bedtime

Customer :

No problem on the date. It must be late for you and I really appreciate your time and expertise.

Dr. Rick :

In the middle, where all the blood vessels are coming out, is the area of the optic nerve called the cup. Think of the nerve as a doughnut...."cup or Hole" in the middle, and pink meat (doughnut) around the edge. Then, in this picture, the meat of the "doughnut" has a crescent of peripapillary atrophy. Does that make sense/

Dr. Rick :

As a retina doc I am positive you have nothing to worry about. Sorry that your ophthalmologist didn't take the time to explain things better to you.

Customer :

Yes. I see it now. Thanks. I'm an orthodontist and type A as I am sure you are, too. I have a new appreciation for retinal problems since the onset of my first PVD and want to do whatever I can to insure the best retinal health possible. Do you recommend any retinal baseline exam now or just continue with my basic opthomology exams?

Dr. Rick :

My entire family are DDS, 2 general and one periodontist....so I understand completely :)

Dr. Rick :

I think you will be OK with a general, baseline, ophthalmology course. No need to come see any of the (highly intelligent, funny) retina doctors in your area.

Dr. Rick :

Can't be a surgeon without being type A....just ask my nurses

Customer :

Thanks. Wish I knew where you were? Can you share this info?

Dr. Rick :

I am in Northern California. How about you?

Dr. Rick :

Oops....I really am tired! I'm in Northern Wisconson. I best get to sleep before I forget my own name

Customer :

The other side of the country. Augusta Georgia - home of the Masters if you are a golfer. Still, as long as nothing acute, it is only a plane hop away.

Customer :

Well, Wisconson is better.

Dr. Rick :

Even closer. Say Hi to Tiger for me.

Dr. Rick :

Never took up golf. Horses and hunting things that fly

Customer :

I don

Customer :

I get to go (can usually get a ticket or two) but I only get to see him on the course. Its a great day. I do have 50 Tennessee Walking Horses - so you own any? Used to raise bird dogs.

Dr. Rick :

Just had to put down my best friend a little bit ago. Tennessee walker stud named Range. About 15.2H, Sorrel. Wonderful horse. For the first time in 50 years I currently am horseless. But, I've taken up snowmobiling and you don't have to feed 'em when you are not riding 'em. I've also owned Icelandics and quarter horses over the years

Dr. Rick :

See. I knew I should have listened to my Dad and went to dental school. Then I could be an orthodontist making enough bucks to feed 50 horses instead of starving as a retina surgeon.

Customer :

I am sorry about Range. They become great friends and I have lost my two initial horses I had when I began field trialing years ago - kidney disease and liver disease. I stand a TWH stud, Seve, at MTSU Horse Science Center in Murfreesboro TN.

Dr. Rick :

sounds like a lot of fun.

Customer :

It is a challenge in the economy feeding and vet - ting all - call me if you need a horse. I have extras! Look under XXXXXXXX in Augusta GA

Dr. Rick :

I will keep that in mind. Time for this old man to get to bed -- surgery tomorrow. Take care and don't forget to press that pretty green button.

Customer :

And I don't make the big bucks - just spend it all on hay and feed.

Customer :

I will and thanks, XXXXX XXXXX

Dr. Rick :

Let me know if I can be of any further help. I'll be here.

Customer :

Goodnight.

Dr. Rick :

I believe that!

Dr. Rick :

night

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