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Blood supply to the Eye. Leo Semes, OD. Case Report. 75 WM Reports the following “. . .at church last week it looked like I was seeing through cracked glass.” What additional information do you want from this history?. Cracked glass vision in a 75 WM. Has it happened before / since?

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case report
Case Report
  • 75 WM
  • Reports the following

“. . .at church last week it looked like I was seeing through cracked glass.”

  • What additional information do you want from this history?
cracked glass vision in a 75 wm
Cracked glass vision in a 75 WM
  • Has it happened before / since?
  • How long did it last?
  • Was it one eye or both? Which one?
  • Did you experience any other symptoms?
cracked glass vision in a 75 wm4
Cracked glass vision in a 75 WM
  • What other tests would you do?
    • VA
    • Anterior segment evaluation
    • Tonometry
    • Fundus evaluation
  • Results: All unremarkable for age
cracked glass vision in a 75 wm5
Cracked glass vision in a 75 WM
  • What other tests would you do?
    • Carotid auscultation
    • Ophthalmodynamometry
    • Further carotid testing
    • General physical / vascular assessment
  • Results:
how would you manage this patient
How would you manage this patient?
  • Further testing for carotid assessment
  • BP
cracked glass vision in a 75 wm7
Cracked glass vision in a 75 WM
  • What could be the cause?
    • Local (vitreous traction)
    • Vascular
      • Retinal vasculature
      • Ophthalmic artery
      • Carotid artery
      • Vertebral basilar
    • Other?
blood supply to the eye8
Blood supply to the eye

Branches of internal carotid artery:

a = internal carotid artery

b = vertebral artery

c = basilar artery

d = ophthalmic artery

e = anterior cerebral artery

f = middle cerebral artery

g = posterior cerebral artery.

cracked glass vision in a 75 wm10
Cracked glass vision in a 75 WM
  • Outcomes
    • Carotid Doppler performed
      • Demonstrated > 90% blockage on left side
      • Patient recommended for L carotid endarterectomy
      • Successfully performed X 2 days
    • Patient survived an additional 7 years (succumbing to emphysema)