4 Photos - Jun 1, 2013
Photo: What is this? Clue #1. This color image was taken with the Optos 200 degree scanning laser ophthalmosope. Notice the appearance of the optic nerve head.Photo: What is this? Clue #2. This is the fellow eye.Photo: What is this? Clue #3. This is an FA image of the right eye. Compare this to the color image of the right eye.Photo: What is this? Clue #4. This, of course, is the giveaway. This is an anterior segment image of the patient's congenital posterior subcapsular cataract, which she has in both eyes. The dark image that appears to be on the retina is actually an image of the cataract. This happens because the scanning laser has excellent depth of field (depth of focus), unlike conventional fundus cameras, which have poor depth of field. Clue #1: A hemorrhage or lesion on the retina would not move past the rim of the optic nerve. Clue #2: It is very unlikely that such a hemorrhage or lesion on the retina would be bilateral. Clue #3: When you compare the color and FA images of the same eye, you notice that the lesion appears to have moved location with regards to the retina, which would leave you to believe the object is anterior to the retina.