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Hi. I'm online and happy to answer your question today.
What is your opinion on my sons situation with the eye problem??
I still do no have any replies. Is there a problem???
Hi. Sorry about that. I had to get ready to go to the office so I stepped away from my computer for a bit.
It sounds like you son is having bleeding in the central part of his eye, an area called the macula. It is also possible that the doctors are using the injections of avastin or lucenits to try and control bleeding in other areas in the back of his eye.
I treat patients with both Eales disease and Coats disease as well as other problems as they apply to the back of the eye and the retina. The two disease processes you mentioned are different in their clinical presentation, with Eales disease being a diagnosis of exclusion rather then diagnosed based on specific clinical findings.
Since you didn't mention anything about your son's left eye I am wondering if that eye is normal on exam. If this is the case, Coats disease might be more probable since this is almost always seen in one eye only. In 90% of cases Eales disease is found in both eyes.
In any event if you son is not being treated by a retina specialist he needs to be. There are many more differences between the two disease processes you mentioned and I'll be happy to go over them with you in detail as well as review your son's current clinical findings and treatments. I will be online off and on for the remainder of the day (it is currently 7:30 AM here) and look forward to chatting with you. Sorry I missed you earlier this morning.
Since you are offline I am going to switch to the Q&A format. We can use the Q&A system to 'text message' each other. An email will be sent to each of us every time something is posted to this thread. While this system is a little bit slower then chat it will allow each of us to know when the other is online and has posted something......
Hi. My system shows you are online and in the chat room.......are you there?
yes i am
Great! What would you like to know in more detail? I am a retina specialist.
my sons left eye has 20/20 vision and so far has shown no signs of disease??
that is good. Do you know anything more about what the back of his eye looks like and why (and what) they are injecting into his eyes? Also, how long has this been going on?
he first brought it to my attention on the 5th july that his vision in his right eye was blurred, i immediately took him to an
Here is a link to a couple of brief articles on eales and coats....you may have already found them:
I see you are typing....I'll standby
opticianwho did a 3d scan and said he could see a mass of blood behind the eye and that he needed to see an opthalmic surgeon immediately. He got me an appoinment the following morning and the surgeon didnt seem to preturbed saying that it could go as quick as it had come. However, due to him being only 16 he made an appointment for him to have a full mot in the hospital which happened at the end of august. After doing a fleurosine test 2 problems arose 1. the rim of the retina should detached abnormal cells 2. the fluid amount had gone up 200 microns. He did laser treatment for the abnormal cells and on a future visit this seems to have worked but the fluid actually rose to 700 microns. that is why he gave a series of 3 vascular injections to try and dry up the blood
Ok. It sounds like he has had some bleeding and swelling in the center of his vision, in an area of the retina called the macula. The injections, most likely of a drug called either Avastin or Lucentis, work by making the leaking blood vessels (choroidal neovascularization) go away.
From what you have told me I would not be thinking of either coats or eales disease at this point. Is your son real nearsighted (highly myopic), have diabetes or any other diseases or recent illnesses?
no we had him fully checked for diabetes and he has never had any problems with his eyesight up to this. There are 5 members in our family and none of us thank god ever had problems with eyesight. His grandmother is 88 yrs and can read without any glasses i have developed short sightedness in the past 5 yrs but i think this is normal at my age this is why we find the situation so alien. His consultant says the if he was a 75 yr old man with diabetes that would explain it but he is a healty sports mad 16 yr old who plays football, soccer at a high competitve standard
Ok. I understand. Here is what I think. Your son is getting very good care for the signs and symptoms of what is happening in his right eye. That is the most important thing at the moment.
Now. Why has this happened? Sometimes this question has no answer. If I was in your shoes, and as a parent myself currently of two teenage boys along with 3 adult girls, it would be good if you could get your son in to see a retina specialist for a complete examination. Perhaps the underlying issues can be discovered either by this sub-specialist or by a team of doctors at a University Teaching Hospital, such as Moorfield's.
yes well thank you very much for support its good to know. During his last visit the test showed that the fluid had gone down to 500 microns so maybe something is working however my son says that his sight is still the same. i am from republic of ireland so i dont think such a hospital exists??? We have a professor O Keeffee and i was thinking of asking for a referral letter for him if the 3rd vasuclar injection hasnt worked. We dont see his surgeonn til Nov 28th 2011. What would the next step be if these injections havent worked???
It does sound like the injections are working. Also, I would expect your son's vision improvement to lag behind the clinical thinning of the macula. If this doesn't work? More laser and a workup for any possible underlying causes with the plan of attacking things that way. Moorfield's is in London, if you can get there. An examination by Dr. OKeeffe
I found a link to Dr. Michael O'Keeffe at Mater Private Hospital. He looks like a good ophthalmologist but he doesn't seem to be a retina specialist.
You might ask Professor O'Keeffe for a name of a retina specialist he likes. I bet he knows at least one. I'm sorry, but I don't know any retina docs in your area.....
Do you know of any retina specialists operating in ireland? im sure the Royal Victoria Eye & Ear in dublin is bound to have a retina specilaist? Would you have a contact name for a retina specialist in Moorfield ???
I don't personally know any of the retina docs at Moorfield's but I'd bet any and all of them are well trained. Here is a link to their site:
Dr. Mark Cahill at The Royal Victoria hospital is a retina specialist. There seem to be a number of retina docs there......I think your son would be well treated by them. Here is a link to their webpage:
thats brilliant thanks a million for all the information, links etc. i feel much more at ease now. His Dr name isXXXXX
My pleasure. Glad to be of help.
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