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818-552-5040
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Kent W. Small, MD

Board-Certified: American Board of Ophthalmology

Fellowship: Vitreoretinal Diseases and Surgery, Duke University Eye Center, Durham, NC; Molecular Genetics, Duke University School of Medicine, Durham, NC

MD: Tulane University School of Medicine, New Orleans, LA

Specialized care for retinal diseases:

  • Macular degeneration
  • Diabetic retinopathy
  • Retinal tears & detachments
  • Inherited retinal diseases
  • Retinal vascular disease
  • Macular holes
  • Macular puckers
  • Macular edema
  • Proliferative vitreoretinopathy/scar tissue

State-of-the-art diagnostic exams:

  • Fluorescein & indocyanine green (ICG) angiography
  • Fundus photography
  • Scanning laser ophthalmoscopy (SLO)
  • Ultrasound A & B scans
  • Visual field testing
  • Microperimetry
  • Optical coherence tomography (OCT)

Ocular Histoplasmosis Syndrome

Ocular histoplasmosis syndrome (OHS) is a major cause of visual impairment in the eastern and central United States, where 90% of adults have been exposed to Histoplasma capsulatum. This common fungus is found in molds from soil enriched with bat, chicken, or starling droppings and yeasts from animals.

Although the fungus is not found directly in the eye, people with OHS usually test positive for previous exposure to Histoplasma capsulatum.

Histoplasmosis is usually mistaken for a cold. The symptoms are very similar. The body’s immune system normally overcomes the infection in a few days. Generally, “histo spots,” or small scars in the retina, do not affect vision, but for unknown reasons, some people can have ocular complications years or decades later.

Doctors believe that the histoplasmosis spores travel from the lungs to the eye where they settle in the choroid, the layer of tiny blood vessels that provide blood and nutrients to the retina, the light-sensing layer of cells lining the back of the eye.

A medical eye examination is the only way to discover any changes inside your eye. If your ophthalmologist, Dr. Kent Small, finds diabetic retinopathy, he or she may order color photographs of the retina, a special test called fluorescein angiography, or optical coherence tomography (OCT) to find out if you need treatment.

Ocular histoplasmosis can affect vision when fragile, abnormal blood vessels grow under the retina. These abnormal blood vessels form a lesion known as a choroidal neovascularization (CNV). If left untreated, the CNV lesion can turn into scar tissue and replace the normal retinal tissue in the macula.

The only proven treatment for OHS is a form of laser surgery called photocoagulation. The laser’s small, powerful beam of light destroys the abnormal blood vessels as well as a small amount of the retinal tissue. Other treatments, including steroids and intraocular injections, are sometimes used. Treatment is not necessary unless the new vessels are in the macula, the part of the retina responsible for acute central vision.

Although only a very small number of people infected with the histoplasmosis virus develop OHS, if you have been exposed to histoplasmosis, you should be sensitive to any changes in your eyesight, and you should monitor your vision using an Amsler grid test at home.

Cedars-Sinai medical towers | 8635 West 3rd Street, Suite 395-W, Los Angeles, CA 90048 | Tel: (310) 659-2200 | Fax: (310) 659-2822 Glendale Office | 501 North Orange Street Suite 250, Glendale, CA 91203 | Tel: (818) 552-5040 | Fax: (818) 552-5044

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