How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr. Rick Your Own Question

Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7759
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
Type Your Eye Question Here...
Dr. Rick is online now
A new question is answered every 9 seconds

i have 16 yr old son who has had 3 vascular injections to this

Resolved Question:

i have 16 yr old son who has had 3 vascular injections to this eyeball due to a 70% sight loss in his right eye but still the opthalmic surgeons dont know whether this is an eye disease or a hereditary disease and dont know what the long term results may be. As a family we are very worried for our childs sight going into the future.Coates disease and Eales disease have both been mentioned. would you have any insight into this problem please???
Submitted: 2 years ago.
Category: Eye
Expert:  Dr. Rick replied 2 years ago.

Dr. Rick :

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

Customer:

What is your opinion on my sons situation with the eye problem??

Customer:

I still do no have any replies. Is there a problem???

Dr. Rick :

Hi. Sorry about that. I had to get ready to go to the office so I stepped away from my computer for a bit.

Dr. Rick :

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.

Dr. Rick :

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.

Dr. Rick :

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.

Dr. Rick :

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.

Dr. Rick :

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......


 

Dr. Rick :

Hi. My system shows you are online and in the chat room.......are you there?

Customer:

yes i am

Dr. Rick :

Great! What would you like to know in more detail? I am a retina specialist.

Customer:

my sons left eye has 20/20 vision and so far has shown no signs of disease??

Dr. Rick :

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?

Customer:

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

Dr. Rick :

Here is a link to a couple of brief articles on eales and coats....you may have already found them:

Dr. Rick :

http://en.wikipedia.org/wiki/Eales_disease

Dr. Rick :

http://www.palmettoretina.com/learn/conditions/coats_disease.html

Dr. Rick :

I see you are typing....I'll standby

Customer:

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

Dr. Rick :

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.

Dr. Rick :

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?

Customer:

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

Dr. Rick :

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.

Dr. Rick :

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.

Customer:

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???

Dr. Rick :

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

Dr. Rick :

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.

Dr. Rick :

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.....

Customer:

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 ???

Dr. Rick :

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. Rick :

http://www.moorfields-private.co.uk/home

Dr. Rick :

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:

Dr. Rick :

http://www.rveeh.ie/rveeh/departments/Ophthalmology.html#Consultants

Customer:

thats brilliant thanks a million for all the information, links etc. i feel much more at ease now. His Dr name isXXXXX

Dr. Rick :

My pleasure. Glad to be of help.

Dr. Rick :

And, now, the obligatory word from our sponsors: :o)


I hope that this information was helpful for you. Please, allow me get credit for my time and effort in assisting you and press the YES button for this assist. I will be glad to answer additional questions until you are satisfied. Thank you very much.

Positive Feedback and/or Bonus is welcomed and appreciated.


 


Let me know if there are there any other concerns or issues you would like to discuss on this topic.


 


If you have a chance drop me a note and let me know how things turn out. You can post to this thread or ask for me at the main screen at no additional charge.


 

Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7759
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you
Expert:  Dr. Rick replied 2 years ago.
What Happens Now?

Your chat has ended, but you can still work with your Expert to get an answer to your question if you have not yet received one.

Come back to this page at any time to see additional information from your Expert.  You will also receive an email when your question is updated.  If you want to send a message to your Expert, use the box below.

If you have already received a satisfactory answer to your question, click the Accept button above.  Experts are credited for each accepted answer they provide.
Expert:  Dr. Rick replied 2 years ago.
I hope your son's vision improves soon and you get to the bottom of what caused all of this. Take care and have a good day.

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O. USA
< Last | Next >
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O. USA
  • Wonderful service, prompt, efficient, and accurate. Couldn't have asked for more. I cannot thank you enough for your help. Mary C. Freshfield, Liverpool, UK
  • This expert is wonderful. They truly know what they are talking about, and they actually care about you. They really helped put my nerves at ease. Thank you so much!!!! Alex Los Angeles, CA
  • Thank you for all your help. It is nice to know that this service is here for people like myself, who need answers fast and are not sure who to consult. GP Hesperia, CA
  • I couldn't be more satisfied! This is the site I will always come to when I need a second opinion. Justin Kernersville, NC
  • Just let me say that this encounter has been entirely professional and most helpful. I liked that I could ask additional questions and get answered in a very short turn around. Esther Woodstock, NY
  • Thank you so much for taking your time and knowledge to support my concerns. Not only did you answer my questions, you even took it a step further with replying with more pertinent information I needed to know. Robin Elkton, Maryland
 
 
 

Meet The Experts:

 
 
 
  • Dr. Dan B.

    Board Certified Ophthalmologist

    Satisfied Customers:

    2903
    Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
< Last | Next >
  • http://ww2.justanswer.com/uploads/DoctorDanB/2010-6-7_6228_just_answer_profile_picture_60_pixels.jpg Dr. Dan B.'s Avatar

    Dr. Dan B.

    Board Certified Ophthalmologist

    Satisfied Customers:

    2903
    Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
  • http://ww2.justanswer.com/uploads/anupamadesai/2010-04-13_122313_Dr._A.S.Desai_new_photo.jpg Dr. A.S. Desai's Avatar

    Dr. A.S. Desai

    Ophthalmologist

    Satisfied Customers:

    1903
    MS Ophthalmology with 11 years of surgical expereince
  • http://ww2.justanswer.com/uploads/gsokoye/2009-10-28_181751_Dr._Stan.JPG Dr. Stan's Avatar

    Dr. Stan

    Ophthalmologist

    Satisfied Customers:

    895
    Johns Hopkins Fellowship Trained, Certified and Licensed Medical Physician and Surgeon
  • http://ww2.justanswer.com/uploads/eyemd/2009-04-07_180315_pic.jpg Dr. Stevens's Avatar

    Dr. Stevens

    Ophthalmologist

    Satisfied Customers:

    629
    Board Certified Ophthalmologist
  • http://ww2.justanswer.com/uploads/CO/CorneaDoc/2012-2-18_0390_photo6.64x64.jpg Dr. Susan's Avatar

    Dr. Susan

    Ophthalmologist

    Satisfied Customers:

    217
    Board Certified & Fellowship trained eye surgeon.
  • http://ww2.justanswer.com/uploads/neuph94/2009-10-11_164729_gif_pic.GIF Dr. JP's Avatar

    Dr. JP

    Ophthalmology, Oculoplastic Surgery

    Satisfied Customers:

    28
    Harvard Medical School, Massachussetts Eye and Ear
  • http://ww2.justanswer.com/uploads/JA/JACUSTOMERjcufyksv/2012-3-13_44825_crop3.64x64.jpg Dr-Trace's Avatar

    Dr-Trace

    Board Certified Ophthalmologist

    Satisfied Customers:

    26
    Board Certified in General Ophthalmology
 
 
 

Related Eye Questions