![]() Certain eye diseases also predispose individuals to retinal detachment, including retinoschisis or lattice degeneration, in which the retina separates into two layers or thins out, respectively ( 2). Those at risk include individuals with personal or family history of retinal detachment, traumatic eye injury, prior eye surgery, diabetic retinopathy, posterior vitreous detachment, degenerative myopia, and certain genetic disorders, such as Marfan's or Stickler's syndrome. The annual incidence is about 1 in 10,000 or about 1 in 300 over a lifetime ( 3). Some patients report partial loss of their visual fields, which may be described as a veil or shadow cast in one area, while others report seeing flashes or floaters ( 2). Presentation typically includes sudden, painless loss or blurring of vision in the affected eye. It is an urgent medical condition that can cause permanent vision loss or blindness if not identified and corrected rapidly ( 1). Retinal detachment occurs when the neurosensory retina separates from the underlying retinal pigment epithelium. Our case outlines a possible association with the vaccine and emphasizes the importance of ultrasonography in diagnosing time-sensitive medical conditions. She received the COVID-19 vaccine a few days prior. Why Should an Emergency Physician Be Aware of This? We present a rare and unusual case of simultaneous bilateral retinal detachments in a healthy, young woman with no major medical history or medications. Although the patient denied any preceding trauma, she did note having received her second dose of the COVID-19 vaccine 10 days before the onset of symptoms. She underwent bilateral vitrectomies for simultaneous rhegmatogenous retinal detachments. She was subsequently seen by ophthalmology and diagnosed with bilateral retinal detachments (macula off in the right, macula on in the left), despite being asymptomatic in her left eye. Point-of-care ultrasound of the eye showed a retinal detachment in the right eye. On examination, her visual acuity with corrective lenses was 20/70 in the right eye, 20/20 in the left eye, and 20/25 with both eyes open. The decision to treat lattice degeneration with laser is not always “black and white” – a discussion with your retina doctor is advised.A 22-year-old woman with myopia but no ocular trauma or other major medical history presented to the emergency department with 5 days of progressive, painless vision loss in her right eye. Sometimes, close observation is appropriate as well as long as the patient is aware of the signs and symptoms of a retinal tear and detachment. Occasionally, prophylactic laser treatment is indicated to treat an area of lattice degeneration to reduce the risk of retinal detachment. About 30% of retinal detachments stem from lattice. Lattice degeneration is a risk factor for the development of a retinal detachment because it is an inherent area of weakness within the retina. When present in one eye, 50% of the time it is present in the other eye as well. Lattice is very common, occurring in about 8% of the population. Although it can come in many different variations, a typical appearance looks like the lattice crust on a fruit pie – a straight, linear, and criss crossed pattern. Lattice degeneration, or simply “lattice” is a degeneration or thinning of the peripheral retina.
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