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Alcohol use during pregnancy can lead to lifelong effects Up to 1 in 20 US school children may have FASDs People with FASDs can experience a mix of the following problems: Physical issues

Common side effects include dry mouth, strange aftertaste, joint aches, and excessive sweating that resolve as the body adjusts

Clinical findings may include: Poor visual acuity Relative afferent pupillary defect Altered red reflex (grey or folded appearance) Reduced visual acuity (if the macula is involved) Visual field defects A sheet of sensory retina billowing towards the centre of the globe Slit lamp examination may reveal a Tobacco dust appearance of the anterior vitreous: a result of pigment cells migrating through a tear in the retina (also known as Shafers sign) Differential diagnoses Possible differential diagnoses in the context of suspected retinal detachment include: Retinoschisis : split within the neurosensory layer (no Tobacco dust sign or corrugated appearance on fundoscopy) Choroidal mass : solid mass associated with fluid which varies with the heads position (no retinal tear or pigment in the vitreous) Investigations Further investigation under a slit lamp with a triple mirror is used to assess for anterior breaks (Figure 3)

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