Coats' Disease (cont.)

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How is Coats' disease diagnosed?

Although it may be diagnosed on a routine eye exam, often it is not suspected until a late stage when a child develops a cloudy white or yellow pupil due to the presence of a cataract or a retinal detachment. In a photograph, the pupil of the affected eye appears yellow or white, while the other pupil appears to be normal black.

It may be diagnosed on a routine eye exam, at which time a cataract might be seen or abnormal blood vessels may be seen at the back of the eye when the pupil is dilated. On an eye examination, the pupil is dilated which enables the physician to see abnormalities of blood vessels or a retinal detachment. Retinal damage may be seen due to the accumulation of cholesterol deposits in the vessels. Lastly, glaucoma and atrophy of the optic nerve may occur.

Since it usually develops slowly, often it isn't diagnosed until late since the individual usually adapts to the slow progressive loss of peripheral vision in one eye.

Because it may come on gradually in one eye, the patient often doesn't notice the painless decrease of vision. As it progresses, patients may notice the following symptoms from the retinal damage: loss of peripheral vision, light flashes, floaters, or a general loss of vision. Especially in children, the parent may notice a yellow reflex in the pupil (due to a cataract or retinal detachment) when a picture is taken.

Once diagnosed, the individual must be followed by the ophthalmologist on a regular basis, usually annually. The diagnosis is made primarily by looking into the eye with the ophthalmoscope in the ophthalmologist's office. After the diagnosis, it is important that the patient have regular examinations of the good eye in order to keep it healthy.


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