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Ask Dr. Dan B. Your Own Question

Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3204
Experience:  Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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Customer Question

After cataract surgery, I developed a macular edema. Two retina specialist agree that surgery to peel the epiretinal membrane is the only way to correct my blurred visoin. There is NO hole in the macular. One specialist says the recovery is the same as from catarct surgery and no gas bubble is needed. The other specialist says he can do the surgery without a gas bubble but he likes the bubble as added insurance. Is a gas bubble necessry with a seven day face down recovery?
Submitted: 2 years ago.
Category: Eye
Expert:  Dr. Dan B. replied 2 years ago.

Doctor DanB : Hello and thanks for your question. Are you available to chat?
Doctor DanB : Yes, the surgery can be done without the bubble, but if there is such significant edema or elevation of the retina, the retina surgeon may feel that your best chance of recovery of normal retinal function (by resolution of the edema) is tomput the bubble in. While the post-operative positioning may be difficult to deal with, if I were going through with the surgery I wouldn't want to leave anything on the table that would impede my recovery and require further surgery or procedures if it could've been taken care of with the original surgery. Unfortunately this is kind of a judgement call at this point and you're likely going to need to figure out which retinal surgeon you trust more. Does this make sense?
Doctor DanB : Does this information help address your concerns?  Do you have any other concerns or questions about this topic?       It appears as though you are not in the chat room currently.  I am happy to be able to help you today. I will also be happy to answer any other questions until you have the information you need.   If you would like to ask further questions or clarification regarding anything I've said, please let me know and I will be happy to address your concerns. Your feedback is important to me and will help me improve my encounter with future customers.  If this process has been helpful, please rate your encounter with me by providing positive feedback; any bonus you may feel prompted to provide would be welcomed and is appreciated. This does not end our conversation, however-we can continue to discuss any of your concerns without further charges until you are satisfied.  My opinion is solely informative and does not constitute a formal medical opinion or recommendation. For a formal medical opinion and/or recommendation you must see an eye doctor.  Thanks for your inquiry! 
Doctor DanB : Did you have other questions about this?
Customer :

I trust the one more who said no gas bubble was required; however, he was only for a second opinion and my insurance does not cover my surgery with him. I am in no better place than before you answered my question. The decision is left up to me, and I guess I wanted you to say that if the edema is not that bad then the gas bubble is not required. The surgeon that I liked was emphatic that it was not necessary, and the surgeon who would do the preocedure said that was right, the gas bubble is not required, but again, he just likes to use it.

Doctor DanB : Then if there isn't a lot of edema then you very well may be just fine without having the bubble. Unfortunately I haven't examined your eyes, nor have unseen scans of your retina. If there really isn't much edema then you would likely be fine without the bubble.
Customer :

Can I send you a picture of the scan? If yes, I will pay my doctor for the picture and send it to you.

Doctor DanB : You bet. But you shouldn't have to pay for anything more than a medical records request fee.
Customer :

I have the images and report from my doctor. He sent them to me via e mail. How do I send them to you?

Doctor DanB : You can attach them
Doctor DanB : To a post.
Customer :

ENCOUNTER DATE:


8/16/2012 FIRST ENCOUNTER:



8/16/2012




DEMOGRAPHIC INFORMATION


NAME:


Ms. Deeds, Elaine AGE: 68 RACE/SEX:



White/F




DOB:


11/08/1943 SS#:



000000000




HOME PHONE:


(XXX) XXX-XXXX


CELL PHONE: WORK PHONE:


E-MAIL:



ADDRESS:






7900 NW 86 Terrace , Tamarac, FL 33321




REFERRING/PCP E-MAIL FAX PHONE


Quevedo, Araceli , M.D. (XXX) XXX-XXXX (XXX) XXX-XXXX


Quevedo, Araceli, M.D. (XXX) XXX-XXXX (XXX) XXX-XXXX


CHIEF COMPLAINT/HPI:




patient referred by general ophthalmologist for retina evaluation and to rule out ERM OD and


CME OD. Patient underwent CE/IOL OD in May 7th 2012 and even though vision improved after surgery it remained fuzzy



and blurry. Patient saw a retina specialist in Florida that told her the treatment would be with surgery and that is also why



patient is coming to us for a second opinion





OCULAR HISTORY:




CE/IOL OS 10/2011 and OD 05/2012 - ReStore IOLs OU (Dr. Gechtcer)




EYE MEDS:




none




MEDICAL HISTORY:




hypercholesterolemia, chronic back pain (had herniated disc treated with surgery), and migraines




SYSTEMIC MEDS:




simvastatin, Estradilo Progest (hormone replacement), Ibuprofen, Butalbital/Apap/Caffeine




ALLERGIES:




denies drug allergies or adverse reactions




FAMILY HISTORY:




unremarkable




SMOKING/SOCIAL HISTORY:


formerly smoked tobacco products until 1983. Smoked 1 pack a week for 20 years Ex-smoker (finding)


ROS: See form


-------------------------------------------


EXAMINATION


-------------------------------------------------------



GEN:



oriented x 3


MENTAL STATUS: normal W/U by Eduardo Pinto


VISUAL ACUITY:



OD: without correction 20/



50+1 PH: 20/



50+2




OS: without correction 20/


20


PH: 20/


INTRAOCULAR PRESSURE:



OD:






10 mm Hg




OS:


10 mm Hg TIME:



1:30 PM




AMSLER GRID/COLOR PLATES:




no metamorphopsia OU




CONRONTATION VISUAL FIELDS:




full OU




MOTILITY:




orthophoric full ductions OU




RETINA ASSOCIATES OF CORAL SPRINGS


Diseases and Surgery of the Retina and Vitreous


A Subsidiary of


Leon A. Bynoe, M.D.


1881 North University Drive



Suite 112



Coral Springs, Florida 33071


Tel: (XXX) XXX-XXXX






Fax: (XXX) XXX-XXXX



Website: www.RetinaSurgeon.net




PUPILS:




3 mm no afferent pupillary defect OU




SLIT LAMP/EXTERNAL:




ReStore PCIOL(s) OU




DILATION:




cyclopentolate 2%, phenylephrine 10%




VITREOUS:


OD:




possible posterior detachment (PVD)




OS:




moderate syneresis




FUNDUS/PHOTO INTERPRETATION:


OD:




There is an epiretinal membrane causing mild striae through the macula. The peripheral retina is unremarkable.




OS:




The macula, vessels, and periphery are unremarkable.




CUP/DISC: OD


0.1 OS



0.05




OPTICAL COHERENCE TOMOGRAPHY:


OD:




ERM with some loss of foveal depression




OS:




Normal macular architecture; no cysts, no fluid




FUNDUS DRAWING:


IMPRESSION/DIAGNOSES:


1.




macular pucker (362.56) right eye




2.




Pseudophakia (V43.1) both eyes




FUTURE PLAN(S)/ENCOUNTER(S):




follow-up with prior retina specialist; may benefit from vitrectomy/membrane peel OD




RETINA F/U:




as needed




DISCUSSION/INSTRUCTIONS:




Patient instructed to call if severe pain and/or significant vision loss.




RETINA ASSOCIATES OF CORAL SPRINGS


Diseases and Surgery of the Retina and Vitreous


A Subsidiary of


Leon A. Bynoe, M.D.


1881 North University Drive



Suite 112



Coral Springs, Florida 33071


Tel: (XXX) XXX-XXXX






Fax: (XXX) XXX-XXXX



Website: www.RetinaSurgeon.net




DISCUSSION/INSTRUCTIONS:




Patient instructed to call if severe pain and/or significant vision loss.


The risks, benefits, and alternatives to the proposed procedure were discussed in detail with the patient.





Leon A. Bynoe, M.D.


Deeds, Elaine, 8/16/2012


RETINA ASSOCIATES OF CORAL SPRINGS


Diseases and Surgery of the Retina and Vitreous


A Subsidiary of


Leon A. Bynoe, M.D.


1881 North University Drive



Suite 112



Coral Springs, Florida 33071


Tel: (XXX) XXX-XXXX






Fax: (XXX) XXX-XXXX



Website: www.RetinaSurgeon.net




 



 


ENCOUNTER DATE:


8/16/2012 FIRST ENCOUNTER:



8/16/2012




DEMOGRAPHIC INFORMATION


NAME:


Ms. Deeds, Elaine AGE: 68 RACE/SEX:



White/F




DOB:


11/08/1943 SS#:



000000000




HOME PHONE:


(XXX) XXX-XXXX


CELL PHONE: WORK PHONE:


E-MAIL:



ADDRESS:






7900 NW 86 Terrace , Tamarac, FL 33321




REFERRING/PCP E-MAIL FAX PHONE


Quevedo, Araceli , M.D. (XXX) XXX-XXXX (XXX) XXX-XXXX


Quevedo, Araceli, M.D. (XXX) XXX-XXXX (XXX) XXX-XXXX


CHIEF COMPLAINT/HPI:




patient referred by general ophthalmologist for retina evaluation and to rule out ERM OD and


CME OD. Patient underwent CE/IOL OD in May 7th 2012 and even though vision improved after surgery it remained fuzzy



and blurry. Patient saw a retina specialist in Florida that told her the treatment would be with surgery and that is also why



patient is coming to us for a second opinion





OCULAR HISTORY:




CE/IOL OS 10/2011 and OD 05/2012 - ReStore IOLs OU (Dr. Gechtcer)




EYE MEDS:




none




MEDICAL HISTORY:




hypercholesterolemia, chronic back pain (had herniated disc treated with surgery), and migraines




SYSTEMIC MEDS:




simvastatin, Estradilo Progest (hormone replacement), Ibuprofen, Butalbital/Apap/Caffeine




ALLERGIES:




denies drug allergies or adverse reactions




FAMILY HISTORY:




unremarkable




SMOKING/SOCIAL HISTORY:


formerly smoked tobacco products until 1983. Smoked 1 pack a week for 20 years Ex-smoker (finding)


ROS: See form


-------------------------------------------


EXAMINATION


-------------------------------------------------------



GEN:



oriented x 3


MENTAL STATUS: normal W/U by Eduardo Pinto


VISUAL ACUITY:



OD: without correction 20/



50+1 PH: 20/



50+2




OS: without correction 20/


20


PH: 20/


INTRAOCULAR PRESSURE:



OD:






10 mm Hg




OS:


10 mm Hg TIME:



1:30 PM




AMSLER GRID/COLOR PLATES:




no metamorphopsia OU




CONRONTATION VISUAL FIELDS:




full OU




MOTILITY:




orthophoric full ductions OU




RETINA ASSOCIATES OF CORAL SPRINGS


Diseases and Surgery of the Retina and Vitreous


A Subsidiary of


Leon A. Bynoe, M.D.


1881 North University Drive



Suite 112



Coral Springs, Florida 33071


Tel: (XXX) XXX-XXXX






Fax: (XXX) XXX-XXXX



Website: www.RetinaSurgeon.net




PUPILS:




3 mm no afferent pupillary defect OU




SLIT LAMP/EXTERNAL:




ReStore PCIOL(s) OU




DILATION:




cyclopentolate 2%, phenylephrine 10%




VITREOUS:


OD:




possible posterior detachment (PVD)




OS:




moderate syneresis




FUNDUS/PHOTO INTERPRETATION:


OD:




There is an epiretinal membrane causing mild striae through the macula. The peripheral retina is unremarkable.




OS:




The macula, vessels, and periphery are unremarkable.




CUP/DISC: OD


0.1 OS



0.05




OPTICAL COHERENCE TOMOGRAPHY:


OD:




ERM with some loss of foveal depression




OS:




Normal macular architecture; no cysts, no fluid




FUNDUS DRAWING:


IMPRESSION/DIAGNOSES:


1.




macular pucker (362.56) right eye




2.




Pseudophakia (V43.1) both eyes




FUTURE PLAN(S)/ENCOUNTER(S):




follow-up with prior retina specialist; may benefit from vitrectomy/membrane peel OD




RETINA F/U:




as needed




DISCUSSION/INSTRUCTIONS:




Patient instructed to call if severe pain and/or significant vision loss.




RETINA ASSOCIATES OF CORAL SPRINGS


Diseases and Surgery of the Retina and Vitreous


A Subsidiary of


Leon A. Bynoe, M.D.


1881 North University Drive



Suite 112



Coral Springs, Florida 33071


Tel: (XXX) XXX-XXXX






Fax: (XXX) XXX-XXXX



Website: www.RetinaSurgeon.net




DISCUSSION/INSTRUCTIONS:




Patient instructed to call if severe pain and/or significant vision loss.


The risks, benefits, and alternatives to the proposed procedure were discussed in detail with the patient.





Leon A. Bynoe, M.D.


Deeds, Elaine, 8/16/2012


RETINA ASSOCIATES OF CORAL SPRINGS


Diseases and Surgery of the Retina and Vitreous


A Subsidiary of


Leon A. Bynoe, M.D.


1881 North University Drive



Suite 112



Coral Springs, Florida 33071


Tel: (XXX) XXX-XXXX






Fax: (XXX) XXX-XXXX



Website: www.RetinaSurgeon.net




 



 



 





 




Customer :

I don't know how I can attach an e mail to a post. I have tried copying ad pasting. That didn't work. I s there an emial I can forward it to?

Doctor DanB : Unfortunately JustAnswer doesn't let us communicate by email. Can you save the attachment as a file and attach the file to this post.
Customer :

ENCOUNTER DATE:


8/16/2012 FIRST ENCOUNTER:



8/16/2012




DEMOGRAPHIC INFORMATION


NAME:


Ms. Deeds, Elaine AGE: 68 RACE/SEX:



White/F




DOB:


11/08/1943 SS#:



000000000




HOME PHONE:


(XXX) XXX-XXXX


CELL PHONE: WORK PHONE:


E-MAIL:



ADDRESS:






7900 NW 86 Terrace , Tamarac, FL 33321




REFERRING/PCP E-MAIL FAX PHONE


Quevedo, Araceli , M.D. (XXX) XXX-XXXX (XXX) XXX-XXXX


Quevedo, Araceli, M.D. (XXX) XXX-XXXX (XXX) XXX-XXXX


CHIEF COMPLAINT/HPI:




patient referred by general ophthalmologist for retina evaluation and to rule out ERM OD and


CME OD. Patient underwent CE/IOL OD in May 7th 2012 and even though vision improved after surgery it remained fuzzy



and blurry. Patient saw a retina specialist in Florida that told her the treatment would be with surgery and that is also why



patient is coming to us for a second opinion





OCULAR HISTORY:




CE/IOL OS 10/2011 and OD 05/2012 - ReStore IOLs OU (Dr. Gechtcer)




EYE MEDS:




none




MEDICAL HISTORY:




hypercholesterolemia, chronic back pain (had herniated disc treated with surgery), and migraines




SYSTEMIC MEDS:




simvastatin, Estradilo Progest (hormone replacement), Ibuprofen, Butalbital/Apap/Caffeine




ALLERGIES:




denies drug allergies or adverse reactions




FAMILY HISTORY:




unremarkable




SMOKING/SOCIAL HISTORY:


formerly smoked tobacco products until 1983. Smoked 1 pack a week for 20 years Ex-smoker (finding)


ROS: See form


-------------------------------------------


EXAMINATION


-------------------------------------------------------



GEN:



oriented x 3


MENTAL STATUS: normal W/U by Eduardo Pinto


VISUAL ACUITY:



OD: without correction 20/



50+1 PH: 20/



50+2




OS: without correction 20/


20


PH: 20/


INTRAOCULAR PRESSURE:



OD:






10 mm Hg




OS:


10 mm Hg TIME:



1:30 PM




AMSLER GRID/COLOR PLATES:




no metamorphopsia OU




CONRONTATION VISUAL FIELDS:




full OU




MOTILITY:




orthophoric full ductions OU




RETINA ASSOCIATES OF CORAL SPRINGS


Diseases and Surgery of the Retina and Vitreous


A Subsidiary of


Leon A. Bynoe, M.D.


1881 North University Drive



Suite 112



Coral Springs, Florida 33071


Tel: (XXX) XXX-XXXX






Fax: (XXX) XXX-XXXX



Website: www.RetinaSurgeon.net




PUPILS:




3 mm no afferent pupillary defect OU




SLIT LAMP/EXTERNAL:




ReStore PCIOL(s) OU




DILATION:




cyclopentolate 2%, phenylephrine 10%




VITREOUS:


OD:




possible posterior detachment (PVD)




OS:




moderate syneresis




FUNDUS/PHOTO INTERPRETATION:


OD:




There is an epiretinal membrane causing mild striae through the macula. The peripheral retina is unremarkable.




OS:




The macula, vessels, and periphery are unremarkable.




CUP/DISC: OD


0.1 OS



0.05




OPTICAL COHERENCE TOMOGRAPHY:


OD:




ERM with some loss of foveal depression




OS:




Normal macular architecture; no cysts, no fluid




FUNDUS DRAWING:


IMPRESSION/DIAGNOSES:


1.




macular pucker (362.56) right eye




2.




Pseudophakia (V43.1) both eyes




FUTURE PLAN(S)/ENCOUNTER(S):




follow-up with prior retina specialist; may benefit from vitrectomy/membrane peel OD




RETINA F/U:




as needed




DISCUSSION/INSTRUCTIONS:




Patient instructed to call if severe pain and/or significant vision loss.




RETINA ASSOCIATES OF CORAL SPRINGS


Diseases and Surgery of the Retina and Vitreous


A Subsidiary of


Leon A. Bynoe, M.D.


1881 North University Drive



Suite 112



Coral Springs, Florida 33071


Tel: (XXX) XXX-XXXX






Fax: (XXX) XXX-XXXX



Website: www.RetinaSurgeon.net




DISCUSSION/INSTRUCTIONS:




Patient instructed to call if severe pain and/or significant vision loss.


The risks, benefits, and alternatives to the proposed procedure were discussed in detail with the patient.





Leon A. Bynoe, M.D.


Deeds, Elaine, 8/16/2012


RETINA ASSOCIATES OF CORAL SPRINGS


Diseases and Surgery of the Retina and Vitreous


A Subsidiary of


Leon A. Bynoe, M.D.


1881 North University Drive



Suite 112



Coral Springs, Florida 33071


Tel: (XXX) XXX-XXXX






Fax: (XXX) XXX-XXXX



Website: www.RetinaSurgeon.net




 



 



 





ENCOUNTER DATE:


8/16/2012 FIRST ENCOUNTER:



8/16/2012




DEMOGRAPHIC INFORMATION


NAME:


Ms. Deeds, Elaine AGE: 68 RACE/SEX:



White/F




DOB:


11/08/1943 SS#:



000000000




HOME PHONE:


(XXX) XXX-XXXX


CELL PHONE: WORK PHONE:


E-MAIL:



ADDRESS:






7900 NW 86 Terrace , Tamarac, FL 33321




REFERRING/PCP E-MAIL FAX PHONE


Quevedo, Araceli , M.D. (XXX) XXX-XXXX (XXX) XXX-XXXX


Quevedo, Araceli, M.D. (XXX) XXX-XXXX (XXX) XXX-XXXX


CHIEF COMPLAINT/HPI:




patient referred by general ophthalmologist for retina evaluation and to rule out ERM OD and


CME OD. Patient underwent CE/IOL OD in May 7th 2012 and even though vision improved after surgery it remained fuzzy



and blurry. Patient saw a retina specialist in Florida that told her the treatment would be with surgery and that is also why



patient is coming to us for a second opinion





OCULAR HISTORY:




CE/IOL OS 10/2011 and OD 05/2012 - ReStore IOLs OU (Dr. Gechtcer)




EYE MEDS:




none




MEDICAL HISTORY:




hypercholesterolemia, chronic back pain (had herniated disc treated with surgery), and migraines




SYSTEMIC MEDS:




simvastatin, Estradilo Progest (hormone replacement), Ibuprofen, Butalbital/Apap/Caffeine




ALLERGIES:




denies drug allergies or adverse reactions




FAMILY HISTORY:




unremarkable




SMOKING/SOCIAL HISTORY:


formerly smoked tobacco products until 1983. Smoked 1 pack a week for 20 years Ex-smoker (finding)


ROS: See form


-------------------------------------------


EXAMINATION


-------------------------------------------------------



GEN:



oriented x 3


MENTAL STATUS: normal W/U by Eduardo Pinto


VISUAL ACUITY:



OD: without correction 20/



50+1 PH: 20/



50+2




OS: without correction 20/


20


PH: 20/


INTRAOCULAR PRESSURE:



OD:






10 mm Hg




OS:


10 mm Hg TIME:



1:30 PM




AMSLER GRID/COLOR PLATES:




no metamorphopsia OU




CONRONTATION VISUAL FIELDS:




full OU




MOTILITY:




orthophoric full ductions OU




RETINA ASSOCIATES OF CORAL SPRINGS


Diseases and Surgery of the Retina and Vitreous


A Subsidiary of


Leon A. Bynoe, M.D.


1881 North University Drive



Suite 112



Coral Springs, Florida 33071


Tel: (XXX) XXX-XXXX






Fax: (XXX) XXX-XXXX



Website: www.RetinaSurgeon.net




PUPILS:




3 mm no afferent pupillary defect OU




SLIT LAMP/EXTERNAL:




ReStore PCIOL(s) OU




DILATION:




cyclopentolate 2%, phenylephrine 10%




VITREOUS:


OD:




possible posterior detachment (PVD)




OS:




moderate syneresis




FUNDUS/PHOTO INTERPRETATION:


OD:




There is an epiretinal membrane causing mild striae through the macula. The peripheral retina is unremarkable.




OS:




The macula, vessels, and periphery are unremarkable.




CUP/DISC: OD


0.1 OS



0.05




OPTICAL COHERENCE TOMOGRAPHY:


OD:




ERM with some loss of foveal depression




OS:




Normal macular architecture; no cysts, no fluid




FUNDUS DRAWING:


IMPRESSION/DIAGNOSES:


1.




macular pucker (362.56) right eye




2.




Pseudophakia (V43.1) both eyes




FUTURE PLAN(S)/ENCOUNTER(S):




follow-up with prior retina specialist; may benefit from vitrectomy/membrane peel OD




RETINA F/U:




as needed




DISCUSSION/INSTRUCTIONS:




Patient instructed to call if severe pain and/or significant vision loss.




RETINA ASSOCIATES OF CORAL SPRINGS


Diseases and Surgery of the Retina and Vitreous


A Subsidiary of


Leon A. Bynoe, M.D.


1881 North University Drive



Suite 112



Coral Springs, Florida 33071


Tel: (XXX) XXX-XXXX






Fax: (XXX) XXX-XXXX



Website: www.RetinaSurgeon.net




DISCUSSION/INSTRUCTIONS:




Patient instructed to call if severe pain and/or significant vision loss.


The risks, benefits, and alternatives to the proposed procedure were discussed in detail with the patient.





Leon A. Bynoe, M.D.


Deeds, Elaine, 8/16/2012


RETINA ASSOCIATES OF CORAL SPRINGS


Diseases and Surgery of the Retina and Vitreous


A Subsidiary of


Leon A. Bynoe, M.D.


1881 North University Drive



Suite 112



Coral Springs, Florida 33071


Tel: (XXX) XXX-XXXX






Fax: (XXX) XXX-XXXX



Website: www.RetinaSurgeon.net




 



 



 




Customer :

I just saw that some of it went through but not the pictures. I will try to save it as a file. Not sure if I know how to do that.

Doctor DanB : Okay. I'll watch for it.
Customer :

ENCOUNTER DATE:


8/16/2012 FIRST ENCOUNTER:



8/16/2012




DEMOGRAPHIC INFORMATION


NAME:


Ms. Deeds, Elaine AGE: 68 RACE/SEX:



White/F




DOB:


11/08/1943 SS#:



000000000




HOME PHONE:


(XXX) XXX-XXXX


CELL PHONE: WORK PHONE:


E-MAIL:



ADDRESS:






7900 NW 86 Terrace , Tamarac, FL 33321




REFERRING/PCP E-MAIL FAX PHONE


Quevedo, Araceli , M.D. (XXX) XXX-XXXX (XXX) XXX-XXXX


Quevedo, Araceli, M.D. (XXX) XXX-XXXX (XXX) XXX-XXXX


CHIEF COMPLAINT/HPI:




patient referred by general ophthalmologist for retina evaluation and to rule out ERM OD and


CME OD. Patient underwent CE/IOL OD in May 7th 2012 and even though vision improved after surgery it remained fuzzy



and blurry. Patient saw a retina specialist in Florida that told her the treatment would be with surgery and that is also why



patient is coming to us for a second opinion





OCULAR HISTORY:




CE/IOL OS 10/2011 and OD 05/2012 - ReStore IOLs OU (Dr. Gechtcer)




EYE MEDS:




none




MEDICAL HISTORY:




hypercholesterolemia, chronic back pain (had herniated disc treated with surgery), and migraines




SYSTEMIC MEDS:




simvastatin, Estradilo Progest (hormone replacement), Ibuprofen, Butalbital/Apap/Caffeine




ALLERGIES:




denies drug allergies or adverse reactions




FAMILY HISTORY:




unremarkable




SMOKING/SOCIAL HISTORY:


formerly smoked tobacco products until 1983. Smoked 1 pack a week for 20 years Ex-smoker (finding)


ROS: See form


-------------------------------------------


EXAMINATION


-------------------------------------------------------



GEN:



oriented x 3


MENTAL STATUS: normal W/U by Eduardo Pinto


VISUAL ACUITY:



OD: without correction 20/



50+1 PH: 20/



50+2




OS: without correction 20/


20


PH: 20/


INTRAOCULAR PRESSURE:



OD:






10 mm Hg




OS:


10 mm Hg TIME:



1:30 PM




AMSLER GRID/COLOR PLATES:




no metamorphopsia OU




CONRONTATION VISUAL FIELDS:




full OU




MOTILITY:




orthophoric full ductions OU




RETINA ASSOCIATES OF CORAL SPRINGS


Diseases and Surgery of the Retina and Vitreous


A Subsidiary of


Leon A. Bynoe, M.D.


1881 North University Drive



Suite 112



Coral Springs, Florida 33071


Tel: (XXX) XXX-XXXX






Fax: (XXX) XXX-XXXX



Website: www.RetinaSurgeon.net




PUPILS:




3 mm no afferent pupillary defect OU




SLIT LAMP/EXTERNAL:




ReStore PCIOL(s) OU




DILATION:




cyclopentolate 2%, phenylephrine 10%




VITREOUS:


OD:




possible posterior detachment (PVD)




OS:




moderate syneresis




FUNDUS/PHOTO INTERPRETATION:


OD:




There is an epiretinal membrane causing mild striae through the macula. The peripheral retina is unremarkable.




OS:




The macula, vessels, and periphery are unremarkable.




CUP/DISC: OD


0.1 OS



0.05




OPTICAL COHERENCE TOMOGRAPHY:


OD:




ERM with some loss of foveal depression




OS:




Normal macular architecture; no cysts, no fluid




FUNDUS DRAWING:


IMPRESSION/DIAGNOSES:


1.




macular pucker (362.56) right eye




2.




Pseudophakia (V43.1) both eyes




FUTURE PLAN(S)/ENCOUNTER(S):




follow-up with prior retina specialist; may benefit from vitrectomy/membrane peel OD




RETINA F/U:




as needed




DISCUSSION/INSTRUCTIONS:




Patient instructed to call if severe pain and/or significant vision loss.




RETINA ASSOCIATES OF CORAL SPRINGS


Diseases and Surgery of the Retina and Vitreous


A Subsidiary of


Leon A. Bynoe, M.D.


1881 North University Drive



Suite 112



Coral Springs, Florida 33071


Tel: (XXX) XXX-XXXX






Fax: (XXX) XXX-XXXX



Website: www.RetinaSurgeon.net




DISCUSSION/INSTRUCTIONS:




Patient instructed to call if severe pain and/or significant vision loss.


The risks, benefits, and alternatives to the proposed procedure were discussed in detail with the patient.





Leon A. Bynoe, M.D.


Deeds, Elaine, 8/16/2012


RETINA ASSOCIATES OF CORAL SPRINGS


Diseases and Surgery of the Retina and Vitreous


A Subsidiary of


Leon A. Bynoe, M.D.


1881 North University Drive



Suite 112



Coral Springs, Florida 33071


Tel: (XXX) XXX-XXXX






Fax: (XXX) XXX-XXXX



Website: www.RetinaSurgeon.net




 



 I am frustrated as i cannot send the pictures.



 




Customer :

I have sent the pictures via e mail to you at XXXXX@XXXXXX.XXX. Thamks!

Doctor DanB : I'm so sorry. Whenever you send an email address to me during a chat,mthe website blocks this out so I can't see it. I will email the moderators and see if they can get them from you.
Customer :

The lady I spoke to said she could send it you. I hope she can. Thank you again.

Doctor DanB : If you can email it toXXX@XXXXXX.XXX then she can send it to me.
Customer :

Were you able to view my e mail that I sent tp XXXXX@XXXXXX.XXX?

Doctor DanB : Did you send it toXXX@XXXXXX.XXX?
Customer :

Yes, I sent it two times/

Customer :

I am hoping you can view the report. Waiting to hear. Thanks

Doctor DanB : I'm sorry. Not yet. I will investigate.
Customer :

Any luck yet viewing my report and pictures?

Customer :

Since I have not heard from the retina specialist, I assume he was not able to view the report/pictures I e mailed. I sent them to two different e mail addresses supplied by you and am still hoping to hear an opinion about surgery. Thank you

Doctor DanB :

I'm very sorry that, for some unknown reason, the folks at JustAnswer have not been able to get me that scan you've sent--they keep telling me that they haven't received it yet. Please try www.oregoneyedoctor.net to work on getting me your scans. Again, I'm very sorry.

Customer :

How do I send my scan to that address? It is a website. I will try again to send the scan to the email addresses given to me by you and Just Answer. Thanks

Customer :

ENCOUNTER DATE:


8/16/2012 FIRST ENCOUNTER:



8/16/2012




DEMOGRAPHIC INFORMATION


NAME:


Ms. Deeds, Elaine AGE: 68 RACE/SEX:



White/F




DOB:


11/08/1943 SS#:



000000000




HOME PHONE:


(XXX) XXX-XXXX


CELL PHONE: WORK PHONE:


E-MAIL:



ADDRESS:






7900 NW 86 Terrace , Tamarac, FL 33321




REFERRING/PCP E-MAIL FAX PHONE


Quevedo, Araceli , M.D. (XXX) XXX-XXXX (XXX) XXX-XXXX


Quevedo, Araceli, M.D. (XXX) XXX-XXXX (XXX) XXX-XXXX


CHIEF COMPLAINT/HPI:




patient referred by general ophthalmologist for retina evaluation and to rule out ERM OD and


CME OD. Patient underwent CE/IOL OD in May 7th 2012 and even though vision improved after surgery it remained fuzzy



and blurry. Patient saw a retina specialist in Florida that told her the treatment would be with surgery and that is also why



patient is coming to us for a second opinion





OCULAR HISTORY:




CE/IOL OS 10/2011 and OD 05/2012 - ReStore IOLs OU (Dr. Gechtcer)




EYE MEDS:




none




MEDICAL HISTORY:




hypercholesterolemia, chronic back pain (had herniated disc treated with surgery), and migraines




SYSTEMIC MEDS:




simvastatin, Estradilo Progest (hormone replacement), Ibuprofen, Butalbital/Apap/Caffeine




ALLERGIES:




denies drug allergies or adverse reactions




FAMILY HISTORY:




unremarkable




SMOKING/SOCIAL HISTORY:


formerly smoked tobacco products until 1983. Smoked 1 pack a week for 20 years Ex-smoker (finding)


ROS: See form


-------------------------------------------


EXAMINATION


-------------------------------------------------------



GEN:



oriented x 3


MENTAL STATUS: normal W/U by Eduardo Pinto


VISUAL ACUITY:



OD: without correction 20/



50+1 PH: 20/



50+2




OS: without correction 20/


20


PH: 20/


INTRAOCULAR PRESSURE:



OD:






10 mm Hg




OS:


10 mm Hg TIME:



1:30 PM




AMSLER GRID/COLOR PLATES:




no metamorphopsia OU




CONRONTATION VISUAL FIELDS:




full OU




MOTILITY:




orthophoric full ductions OU




RETINA ASSOCIATES OF CORAL SPRINGS


Diseases and Surgery of the Retina and Vitreous


A Subsidiary of


Leon A. Bynoe, M.D.


1881 North University Drive



Suite 112



Coral Springs, Florida 33071


Tel: (XXX) XXX-XXXX






Fax: (XXX) XXX-XXXX



Website: www.RetinaSurgeon.net




PUPILS:




3 mm no afferent pupillary defect OU




SLIT LAMP/EXTERNAL:




ReStore PCIOL(s) OU




DILATION:




cyclopentolate 2%, phenylephrine 10%




VITREOUS:


OD:




possible posterior detachment (PVD)




OS:




moderate syneresis




FUNDUS/PHOTO INTERPRETATION:


OD:




There is an epiretinal membrane causing mild striae through the macula. The peripheral retina is unremarkable.




OS:




The macula, vessels, and periphery are unremarkable.




CUP/DISC: OD


0.1 OS



0.05




OPTICAL COHERENCE TOMOGRAPHY:


OD:




ERM with some loss of foveal depression




OS:




Normal macular architecture; no cysts, no fluid




FUNDUS DRAWING:


IMPRESSION/DIAGNOSES:


1.




macular pucker (362.56) right eye




2.




Pseudophakia (V43.1) both eyes




FUTURE PLAN(S)/ENCOUNTER(S):




follow-up with prior retina specialist; may benefit from vitrectomy/membrane peel OD




RETINA F/U:




as needed




DISCUSSION/INSTRUCTIONS:




Patient instructed to call if severe pain and/or significant vision loss.




RETINA ASSOCIATES OF CORAL SPRINGS


Diseases and Surgery of the Retina and Vitreous


A Subsidiary of


Leon A. Bynoe, M.D.


1881 North University Drive



Suite 112



Coral Springs, Florida 33071


Tel: (XXX) XXX-XXXX






Fax: (XXX) XXX-XXXX



Website: www.RetinaSurgeon.net




DISCUSSION/INSTRUCTIONS:




Patient instructed to call if severe pain and/or significant vision loss.


The risks, benefits, and alternatives to the proposed procedure were discussed in detail with the patient.





Leon A. Bynoe, M.D.


Deeds, Elaine, 8/16/2012


RETINA ASSOCIATES OF CORAL SPRINGS


Diseases and Surgery of the Retina and Vitreous


A Subsidiary of


Leon A. Bynoe, M.D.


1881 North University Drive



Suite 112



Coral Springs, Florida 33071


Tel: (XXX) XXX-XXXX






Fax: (XXX) XXX-XXXX



Website: www.RetinaSurgeon.net




 



 



 




ENCOUNTER DATE:


8/16/2012 FIRST ENCOUNTER:



8/16/2012




DEMOGRAPHIC INFORMATION


NAME:


Ms. Deeds, Elaine AGE: 68 RACE/SEX:



White/F




DOB:


11/08/1943 SS#:



000000000




HOME PHONE:


(XXX) XXX-XXXX


CELL PHONE: WORK PHONE:


E-MAIL:



ADDRESS:






7900 NW 86 Terrace , Tamarac, FL 33321




REFERRING/PCP E-MAIL FAX PHONE


Quevedo, Araceli , M.D. (XXX) XXX-XXXX (XXX) XXX-XXXX


Quevedo, Araceli, M.D. (XXX) XXX-XXXX (XXX) XXX-XXXX


CHIEF COMPLAINT/HPI:




patient referred by general ophthalmologist for retina evaluation and to rule out ERM OD and


CME OD. Patient underwent CE/IOL OD in May 7th 2012 and even though vision improved after surgery it remained fuzzy



and blurry. Patient saw a retina specialist in Florida that told her the treatment would be with surgery and that is also why



patient is coming to us for a second opinion





OCULAR HISTORY:




CE/IOL OS 10/2011 and OD 05/2012 - ReStore IOLs OU (Dr. Gechtcer)




EYE MEDS:




none




MEDICAL HISTORY:




hypercholesterolemia, chronic back pain (had herniated disc treated with surgery), and migraines




SYSTEMIC MEDS:




simvastatin, Estradilo Progest (hormone replacement), Ibuprofen, Butalbital/Apap/Caffeine




ALLERGIES:




denies drug allergies or adverse reactions




FAMILY HISTORY:




unremarkable




SMOKING/SOCIAL HISTORY:


formerly smoked tobacco products until 1983. Smoked 1 pack a week for 20 years Ex-smoker (finding)


ROS: See form


-------------------------------------------


EXAMINATION


-------------------------------------------------------



GEN:



oriented x 3


MENTAL STATUS: normal W/U by Eduardo Pinto


VISUAL ACUITY:



OD: without correction 20/



50+1 PH: 20/



50+2




OS: without correction 20/


20


PH: 20/


INTRAOCULAR PRESSURE:



OD:






10 mm Hg




OS:


10 mm Hg TIME:



1:30 PM




AMSLER GRID/COLOR PLATES:




no metamorphopsia OU




CONRONTATION VISUAL FIELDS:




full OU




MOTILITY:




orthophoric full ductions OU




RETINA ASSOCIATES OF CORAL SPRINGS


Diseases and Surgery of the Retina and Vitreous


A Subsidiary of


Leon A. Bynoe, M.D.


1881 North University Drive



Suite 112



Coral Springs, Florida 33071


Tel: (XXX) XXX-XXXX






Fax: (XXX) XXX-XXXX



Website: www.RetinaSurgeon.net




PUPILS:




3 mm no afferent pupillary defect OU




SLIT LAMP/EXTERNAL:




ReStore PCIOL(s) OU




DILATION:




cyclopentolate 2%, phenylephrine 10%




VITREOUS:


OD:




possible posterior detachment (PVD)




OS:




moderate syneresis




FUNDUS/PHOTO INTERPRETATION:


OD:




There is an epiretinal membrane causing mild striae through the macula. The peripheral retina is unremarkable.




OS:




The macula, vessels, and periphery are unremarkable.




CUP/DISC: OD


0.1 OS



0.05




OPTICAL COHERENCE TOMOGRAPHY:


OD:




ERM with some loss of foveal depression




OS:




Normal macular architecture; no cysts, no fluid




FUNDUS DRAWING:


IMPRESSION/DIAGNOSES:


1.




macular pucker (362.56) right eye




2.




Pseudophakia (V43.1) both eyes




FUTURE PLAN(S)/ENCOUNTER(S):




follow-up with prior retina specialist; may benefit from vitrectomy/membrane peel OD




RETINA F/U:




as needed




DISCUSSION/INSTRUCTIONS:




Patient instructed to call if severe pain and/or significant vision loss.




RETINA ASSOCIATES OF CORAL SPRINGS


Diseases and Surgery of the Retina and Vitreous


A Subsidiary of


Leon A. Bynoe, M.D.


1881 North University Drive



Suite 112



Coral Springs, Florida 33071


Tel: (XXX) XXX-XXXX






Fax: (XXX) XXX-XXXX



Website: www.RetinaSurgeon.net




DISCUSSION/INSTRUCTIONS:




Patient instructed to call if severe pain and/or significant vision loss.


The risks, benefits, and alternatives to the proposed procedure were discussed in detail with the patient.





Leon A. Bynoe, M.D.


Deeds, Elaine, 8/16/2012


RETINA ASSOCIATES OF CORAL SPRINGS


Diseases and Surgery of the Retina and Vitreous


A Subsidiary of


Leon A. Bynoe, M.D.


1881 North University Drive



Suite 112



Coral Springs, Florida 33071


Tel: (XXX) XXX-XXXX






Fax: (XXX) XXX-XXXX



Website: www.RetinaSurgeon.net




 



 



 


ENCOUNTER DATE:


8/16/2012 FIRST ENCOUNTER:



8/16/2012




DEMOGRAPHIC INFORMATION


NAME:


Ms. Deeds, Elaine AGE: 68 RACE/SEX:



White/F




DOB:


11/08/1943 SS#:



000000000




HOME PHONE:


(XXX) XXX-XXXX


CELL PHONE: WORK PHONE:


E-MAIL:



ADDRESS:






7900 NW 86 Terrace , Tamarac, FL 33321




REFERRING/PCP E-MAIL FAX PHONE


Quevedo, Araceli , M.D. (XXX) XXX-XXXX (XXX) XXX-XXXX


Quevedo, Araceli, M.D. (XXX) XXX-XXXX (XXX) XXX-XXXX


CHIEF COMPLAINT/HPI:




patient referred by general ophthalmologist for retina evaluation and to rule out ERM OD and


CME OD. Patient underwent CE/IOL OD in May 7th 2012 and even though vision improved after surgery it remained fuzzy



and blurry. Patient saw a retina specialist in Florida that told her the treatment would be with surgery and that is also why



patient is coming to us for a second opinion





OCULAR HISTORY:




CE/IOL OS 10/2011 and OD 05/2012 - ReStore IOLs OU (Dr. Gechtcer)




EYE MEDS:




none




MEDICAL HISTORY:




hypercholesterolemia, chronic back pain (had herniated disc treated with surgery), and migraines




SYSTEMIC MEDS:




simvastatin, Estradilo Progest (hormone replacement), Ibuprofen, Butalbital/Apap/Caffeine




ALLERGIES:




denies drug allergies or adverse reactions




FAMILY HISTORY:




unremarkable




SMOKING/SOCIAL HISTORY:


formerly smoked tobacco products until 1983. Smoked 1 pack a week for 20 years Ex-smoker (finding)


ROS: See form


-------------------------------------------


EXAMINATION


-------------------------------------------------------



GEN:



oriented x 3


MENTAL STATUS: normal W/U by Eduardo Pinto


VISUAL ACUITY:



OD: without correction 20/



50+1 PH: 20/



50+2




OS: without correction 20/


20


PH: 20/


INTRAOCULAR PRESSURE:



OD:






10 mm Hg




OS:


10 mm Hg TIME:



1:30 PM




AMSLER GRID/COLOR PLATES:




no metamorphopsia OU




CONRONTATION VISUAL FIELDS:




full OU




MOTILITY:




orthophoric full ductions OU




RETINA ASSOCIATES OF CORAL SPRINGS


Diseases and Surgery of the Retina and Vitreous


A Subsidiary of


Leon A. Bynoe, M.D.


1881 North University Drive



Suite 112



Coral Springs, Florida 33071


Tel: (XXX) XXX-XXXX






Fax: (XXX) XXX-XXXX



Website: www.RetinaSurgeon.net




PUPILS:




3 mm no afferent pupillary defect OU




SLIT LAMP/EXTERNAL:




ReStore PCIOL(s) OU




DILATION:




cyclopentolate 2%, phenylephrine 10%




VITREOUS:


OD:




possible posterior detachment (PVD)




OS:




moderate syneresis




FUNDUS/PHOTO INTERPRETATION:


OD:




There is an epiretinal membrane causing mild striae through the macula. The peripheral retina is unremarkable.




OS:




The macula, vessels, and periphery are unremarkable.




CUP/DISC: OD


0.1 OS



0.05




OPTICAL COHERENCE TOMOGRAPHY:


OD:




ERM with some loss of foveal depression




OS:




Normal macular architecture; no cysts, no fluid




FUNDUS DRAWING:


IMPRESSION/DIAGNOSES:


1.




macular pucker (362.56) right eye




2.




Pseudophakia (V43.1) both eyes




FUTURE PLAN(S)/ENCOUNTER(S):




follow-up with prior retina specialist; may benefit from vitrectomy/membrane peel OD




RETINA F/U:




as needed




DISCUSSION/INSTRUCTIONS:




Patient instructed to call if severe pain and/or significant vision loss.




RETINA ASSOCIATES OF CORAL SPRINGS


Diseases and Surgery of the Retina and Vitreous


A Subsidiary of


Leon A. Bynoe, M.D.


1881 North University Drive



Suite 112



Coral Springs, Florida 33071


Tel: (XXX) XXX-XXXX






Fax: (XXX) XXX-XXXX



Website: www.RetinaSurgeon.net




DISCUSSION/INSTRUCTIONS:




Patient instructed to call if severe pain and/or significant vision loss.


The risks, benefits, and alternatives to the proposed procedure were discussed in detail with the patient.





Leon A. Bynoe, M.D.


Deeds, Elaine, 8/16/2012


RETINA ASSOCIATES OF CORAL SPRINGS


Diseases and Surgery of the Retina and Vitreous


A Subsidiary of


Leon A. Bynoe, M.D.


1881 North University Drive



Suite 112



Coral Springs, Florida 33071


Tel: (XXX) XXX-XXXX






Fax: (XXX) XXX-XXXX



Website: www.RetinaSurgeon.net




 



 



 







Doctor DanB : I have received the text of the doctor visits, but unfortunately not the scan. Per the notes of the doctor about the interpretation of the fluorescein angiogram, there doesn't appear to be any macular edema.
Customer : There is macular edema,,and I will be seeing another retina specialist for a third opinion.
Customer : Since Doctor DanB was not able to view the scan, I really am right where I started with no opinion from him. I will be seeing another retina specialist for a third opinion. Your service was good, prompt, but certainly there should have been a way for the doctor to view the scan.

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