10 comments

  1. Stephen Sinclair
    It’s true that VA doesn’t measure functional vision but color vision, visual field findings all show normal. As well as the OCT findings. I don’t think that granulomatous retinitis would provide such normal findings on all these tests.

  2. the diagnosis is absolutely incorrect- the night driving abnormality is due to the bilateral retinal infiltration with what appears to be granulomatous retinitis- active OD, inactive OS.

    1. Thank you for your emphatic diagnosis Dr Sinclair. I believe what you are interpreting as granulomatous retinitis is in fact photographic artifact. Visual acuity is 6/6 (20/20) uncorrected in each eye. Patient was found to have a refractive error of -0.50 D and the optic nerve head pit was merely an incidental finding.

      1. OK- thanks, but the small granulomas OD and scars OS do not look to be artifacts. Remember that visual acuity does not measure functional vision. Although it has been used for more than 180 years (oldest diagnostic tool in medicine in constant use, older than stethoscope), it has never been validated and does not measure vision. You can see my lecture a couple of weeks ago (at Microsoft). https://www.dropbox.com/s/oxi2mn2d46cnm07/%20VIP-%20to%20Assess%20and%20Assist-%20Sinclair%20Lecture%204.18.2019.pptx?dl=0

      2. I don’t disagree with you… however this case just so happens to be one of my daughters and I am her examining ophthalmologist for the past 21 years. I have an unfair advantage in this situation and the retina is normal.

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