Maurice F. Rabb » Retinal Vascular Occlusive Disease

Mr. Elihu Harris is a 35 year old black assemblyman and lawyer from the Oakland area who has had a sequence events in his right eye leading to hemorrhagic glaucoma, retinal detachment and blindness. The right eye is painful and will eventually require enucleation. In spring 1981 he noted floaters in the RE. By fall 1981 the floaters were worse and fluorescein angiograms showed vascular problems in both eyes. Lazer treatments were given three times. Vitreous bands developed. Vitrectomy was done by Geo. Hilton in Jan. 1982. By April 1982 the retina detached and was operated by Dr. Hilton. It was reattached temporarily. Recurrent bleeding continued within the eye. In October 1982 he developed glaucoma and pain. Two glaucoma operations were done in Oakland. He went to Jules Stein Institute where ultrasond showed total retinal detachment, intraocular blood and glaucoma. Steroids are keeping the eye reasonably comfortable. The patient knows that he will need enucleation in due course.

I would like you to evaluate the good eye, for retinal vascular disease. Through a small pupil I noted an eudative retinopathy at the posterior pole that may be associated with microaneurysms. I also noted narrowing of retinal arterioles and a large slightly cupped disc. I went no further with the examination.

Mr. Harris needs expert advise regarding the nature and extent of the retinopathy in his left eye. He also needs advise regarding treatment and prognosis. I am curious if his problem can be related to sickle cell trait, which he apparently has.