This is a 40-year-old male who presented with acute onset of metamorphopsia in the left eye (OS). He was a baseball pitcher in college and had a straight line drive injury to the left eye 20 years prior. This same trauma had also occurred in the right eye (OD) the following year. He had no other ocular history including no history of ocular surgery. His visual acuity was 20/20 OD and 20/30 OS, with normal intraocular pressure OU. There was no relative afferent pupillary defect. Anterior segment exam was normal, except for 360 degrees of angle recession OD and 270 degrees of angle recession OS. Dilated fundus exam was normal OD. There was a curved, fibrotic scar concentric to the disc in the left eye with associated hyperpigmentation and overlying intraretinal hemorrhage. There was also atrophy superiorly. In the infratemporal macular there was a round fibrotic scar with signs of previous intraretinal fluid. OCT OS showed a pigment epithelial detachment with associated subretinal and intraretinal fluid. The patient was diagnosed with a choroidal neovascular membrane and treated with intravitreal avastin.
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