One elderly lady had complaints of diminished vision in the right eye of 15 days duration. She was 69 years old and had already lost vision in the left eye 3 years back. She was not a diabetic or hypertensive. Visual acuity in the right eye was 6/24 and in the left was counting fingers 2 meters. She had Pseudophakia (Intraocular Lens) in both the eyes, having undergone cataract surgery 5 years back. Fundus examination right eye showed a whitish lesion in the macula with surrounding thickening and hemorrhage, while the left eye showed a large scar in the central area (macula).

She underwent Fundus Fluorescein Angiography that showed a well-defined leak in the right eye. The patient was diagnosed as having Choroidal Neovascular Membrane in the right eye and Macular scar in the left eye due to Age Related Macular Degeneration.

It was explained to her that the treatment is aimed only at preventing further visual loss by trying to close the Neovascular Membrane and not at improving vision. The need for regular post treatment follow-ups was also emphasized to detect any recurrences, which are quite common. She was offered the best treatment available for this condition i.e. Photodynamic Therapy (PDT) with the drug Verteporfin. She underwent the same the next day and 3 months later the hemorrhage had resolved and the vision was slightly better at 6/18p. Subjectively she was feeling much better with the reduction in distortion and haziness of vision.

A 62 - year – old gentleman presented with fall in vision in the left eye noticed few days back. On examination visual acuity in the right eye was 6/9 while left eye was 6/36. Intraocular Pressures were normal. Fundus examination was normal in the right eye and in the left eye showed an area of edema with sub retinal hemorrhages in the macula. A choroidal Neovascular Membrane due to age related macular degeneration was suspected, which was confirmed on Fluorescein Angiography.

He was advised to undergo Photodynamic therapy left eye, but he refused to undergo it due to financial reasons. He was then offered Transpupillary Thermotherapy (TTT) but explained that its results are variable and unpredictable. He underwent the same 2 days later. On follow up 1 month later the edema (thickening) and hemorrhages were less than before. At his 6 months follow up the vision in the left eye was still 6/36 and the hemorrhage had markedly reduced.

At tenth month follow up he again had a fall in vision due to recurrence of the Neovascular Membrane. He underwent a repeat TTT after a Fluorescein Angiography and 3 months post treatment the Neovascular Membrane had regressed with vision stabilizing at 6/60. Patient was quite satisfied with the quality of vision post treatment.