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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11231
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I am re-listing this question to get a second opinion. Today

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I am re-listing this question to get a second opinion.
Today my daughter and I went for our annual eye exam. They perform an optional test that actually takes a picture of the entire eye, where you can see blood vessels, veins, tissue, etc. I forgot the name of the machine/test. Anyway my daughter's eyes looked 'healthy' and no signs of diabetes, or any other bad conditions. The dr mentioned a small scar on the back of her eye, and compared it to last year's picture, it was there also but the dr last year never mentioned it. She said that it was scar tissue and some people are born with it and there was absolutely nothing to worry about....yet I feel uneasy because I dont understand how this happens. As I said my daughters eye sight is perfect, and has no other medical issues.If I didnt opt to have this optional imaging done I would have never known.

Dr. Rick :

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

Customer:

Thank you

Dr. Rick :

Do you know if the doctor who diagnosed this scar in the back of your daughter is an optometrist (OD) or an ophthalmologist (MD, can do eye surgery)? I am a retina specialist and deal primarily with diseases in the back of the eye...

Customer:

OD

Dr. Rick :

Ok. It is possible that the optometrist used a special camera that takes a single wide angle picture of the retina (back of the eye). The doctor may not even have dilated your daughters eye first.

Dr. Rick :

This is really not the best way to "find" and "diagnose" a retinal condition....

Customer:

It was an optomap

Dr. Rick :

I am glad to hear that your daughter has good vision. Is she otherwise healthy also?

Customer:

Terrific health. I can only think of one incident where there could have been some trauma. She had minor surgery on the same eye years ago to remove a sliver of metal lodged in the white part of her eye but i fail to see any correlation?

Dr. Rick :

ya, the optomap, in my professional opinion, takes very pretty pictures to show the patient but it is not really useful for treatment or diagnosis.......and most optometrists, I am sad to say, wouldn't know a retinal problem if it reached out and bit them.

Customer:

So she said it was a small 'scar' that was the same size last year on the optomap. Could it have been nothing?

Dr. Rick :

There are a bunch of reasons your daughter could have a retinal scar, even without any history of trauma. The most common is called toxoplasmosis. Another one is histoplasmosis, and then the list just kinda goes on and on. The good news? Since she has no symptoms and has excellent vision, I don't think you (or her :), have anything to worry about.

Dr. Rick :

It is good that it has not changed. Next year, I suggest you dump the optometrist and see an ophthalmologist. That way you will have some idea of what may have caused the scar.

Dr. Rick :

I do not think that you have to rush in for an exam, or make an appointment with a retina specialist (although I am biased on that topic ;) at this point.

Dr. Rick :

While I don't think that the scar is "nothing" I don't think it is anything to worry about...and, yes, the optometrist may not be reading the optomap picture correctly...

Customer:

That is so reassuring. I have been worrying about it way too much. I will definitely see an opthamologist. My only lingering concern is two fold... could it be related somehow to veins or arteries? And am I being negligent if I wait a year? Like I said, if I didnt opt for the test I wouldnt even be worrying at this point.

Dr. Rick :

At 10 years old I highly doubt that your daughter has a vascular problem. Also, she is to be praised for sitting still enough to have the optomap take a picuture :)

Dr. Rick :

and the Optometrist should be ashamed he used it on a healthy little girl

Dr. Rick :

who has no need of this procedure being done, let alone billed for it.

Dr. Rick :

If you are worried get her into a pediatric ophthalmologist (they are best equipped to examine young folks) sooner, but I think next year is fine.

Dr. Rick :

So. Tell me. Am I saying about the same thing as the last ophthalmologist you talked to or am I way off base?

Dr. Rick :

Still there?

Customer:

You are a God send. You have made a world of difference to my worried mind. So, make an appointment with an opthamologist in the next year. I'm definitely kicking the other one to the curb! A milllion thank yous! The other online doc basically said the same thing but

Dr. Rick :

My pleasure. Let me know if I can do anything else to help you.

Customer:

was less reassuring in his response. I felt an urgency to go to an opthamologist tomorrow. His bedside manner was not as reassuring as yours.

Dr. Rick :

Well, retina is what I do and I feel fairly confident, based on what you have told me, that your daughter will be just fine.

Dr. Rick :

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Customer:

He mentioned toxoplasmosis and said it could return and I had to find out WHY she has a scar.

Customer:

Sorry! No more responses. Thank you = )

Dr. Rick :

Toxoplasmosis can reactivate, that is true....but she will have symptoms (usually) if that occure.

Dr. Rick and other Eye Specialists are ready to help you
Let me know if there are there any other concerns or issues you would like to discuss on this topic.