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An 11-month-old girl with a retinal detachment
Digital Journal of Ophthalmology 2019
Volume 25, Number 2
May 11, 2019
DOI: 10.5693/djo.03.2019.02.004
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Vinay Badhwar, MBBS, BSc | Barts and The London, School of Medicine and Dentistry, London, United Kingdom
Damien Yeo, MBBS, FRCOphth | Royal London Hospital, Barts Health Trust; Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom
Samruddhi Joshi, BSc | Barts and The London, School of Medicine and Dentistry, London, United Kingdom
Sui Chien Wong, MBBS, FRCSEdOphth, MRCOphth, PGC | Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom; Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom; Royal Free Hospital, London, United Kingdom
Ashwin Reddy, MD, MBBChir, FRCOphth | Royal London Hospital, Barts Health Trust; Moorfields Eye Hospital NHS Foundation Trust,London, United Kingdom



Examination
On examination, the child objected to occlusion of the right eye and was not able to fix and follow consistently with the left eye. Pupils appeared to be normal, with no manifest strabismus. A relative afferent pupillary defect was not established. On indirect fundoscopy, a yellow pupillary reflex (xanthocoria) was seen in the left eye. The right eye appeared normal. On examination under general anesthesia, the anterior segment of each eye showed no abnormal neovascularization or tumor seeds, and the horizontal corneal diameters were within normal limits. Intraocular pressure was normal in both eyes. On posterior segment examination, a total retinal detachment was noted in the left eye (Figure 1); indirect ophthalmoscopy revealed yellow, subretinal exudation, and there were also anomalous retinal vessels. Fundus images were captured with the RetCam 3 (Clarity Medical Systems Inc, Pleasanton, CA).
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Figure 1
 Fundus photograph showing vascular abnormalities in the retina with a yellow, bullous retinal detachment.


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