So the final determination after September's vision loss was that she has dragging of the macula in her right eye. This can cause unpredictable loss of acuity, with some patients with severe dragging having perfect acuity, and some patients with mild dragging having severe loss of acuity. There's nothing to be done about this, new glasses won't fix it. She now has permanent uncorrectable vision loss in that eye.

Tamara came to me last Friday complaining of sparkling lights in her vision in both eyes. She also thought she might have more floaters than usual, and was having trouble focusing on print. We called Dr. Trese and they said to bring her in on Tuesday. Over the weekend, she reported having an easier time reading print, but the lights and floaters were still there.

Tamara had her visit with Dr. Trese today. No new retinal changes, and no new exudates. She has scored a little better on her acuity than last time. However, Dr. Trese observed fresh organized vitreous. This is where the fluid inside the eye becomes almost stringy, and the strands can get stuck on structures in the eye (like the retina) and pull on them. This can lead to retinal folds, tears, and detachments, and is one of the main disease processes in FEVR. The tension on her retina from the organized vitreous is most likely the cause of the sparkles she has been seeing. He doesn't feel that the risks of a vitrectomy (removing all the vitreous fluid inside the eye, sometimes also scraping the retina, and then replacing it with saline) are worth the benefits right now, but he wants to follow her more closely to monitor the organization, and she's to come straight back if it gets any worse.

Ugh.