MITTENDORF'S DOT

This is a small dot on the back of the lens. It is a remnant of a fetal artery that ran from the back of the eye to the front during development. This artery usually disappears completely but in some people a dot remains. It is of no consequence to the vision .

TRICHIASIS DAMAGE

This is the same patient below. If you magnify this image you'll see damaged epithelial cells from the eyelashes rubbing against the eye.

SCLERAL THINNING & TRICHIASIS

You can see little dark spots on the white part of the eye (between the blood vessels). These dark areas are from "scleral thinning". The sclera is the thickest layer of the eye, separating the inner, dark, choroid layer of the eye from the outer, clear, conjunctiva layer. As we age, the sclera can become thin to the point that you can see the deeper choroid layer. This scleral thinning is of no negative consequence to the eye or vision . There are other types of scleral thinning associated with arthritic-like conditions, but this is not that type.

You can also see eyelashes growing in the eye. These lashes cause irritation to the surface of the eye. I pulled (epilated) these lashes. They tend to grow back however every 3-4 weeks. This "trichiasis" is also somewhat age-related, but other factors can be involved.

GLAUCOMA

These are the optic nerves of a patient with glaucoma. There is very little rim tissue and large cupping in the middle. Glaucoma occurs primarily when high pressure in the eye pinches off the blood supply to nerve tissue, causing permanent damage to that tissue and stealing the vision slowly until complete blindness occurs.

LENS OPACITIES

These are small opacities in the peripheral lens cortex in a 33 year old female. These opacities are likely developmental and not progressing. They do not interrupt the vision.

FAMILIAL DOMINANT DRUSEN

This is a picture of a gentleman in his late 30's. If you enlarge the photograph you can see little white dots. This is a photo of the macular area of the eye, that area that serves the central vision.

These little white dots are called drusen, and in a person past 60 years old, we would consider this macular degeneration. But in a younger person like this, the most likely cause is familial dominant drusen, which is hereditary lipid (or fat-like) deposits in the layers of the retina. It typically does not affect the vision and only a very small number of these patients eventually develop age-related macular degeneration.

There is one interesting condition called mesoangiocapillary membraneoproliferative glomerulonephritis that causes a similar look on the retina. But those patients have blood and excessive protein in the urine and renal family. This patient was healthy with 20/20 vision in each eye.

CONGENITAL CATARACTS

This patient has small congenital cataracts. You should see a very faint, white dot in the center of the pupil. That small white dot is the opacity (any opacity in the lens of the eye is called a cataract). This particular type of cataract was present at birth and should not get worse with time. It only minimally affects the vision in the left eye of this patient (lower photo). These cataracts are anomalies of fetal development.

RETINOSCHISIS

This is really difficult to see and may required you click on the photo and enlarge it. This is a picture of a gentleman's retina in the superior temporal retina of the right eye. In the lower right, if you look close, the retina appears to bubble up. This bubbling up is not a retina detachment, but a "retinoschisis". A retinoschisis occurs when the outer layer of the retina pulls away from the inner layer of the retina, and then bubbles up. The retina is still attached because the inner layer is attached.

Retinoschisis generally does not lead to a ful retina detachment, but needs to be watched closely to see if risk for detachment increases.