Patient presents with complaints possibly related to myelinated retinal nerve fiber layer (MRNF).  Symptoms reported include visual field defects such as scotomas, enlarged blind spot, or decreased visual acuity, although many patients are asymptomatic.  Fundoscopic examination reveals characteristic feathery, white, opaque patches adjacent to the optic disc, consistent with myelination extending from the retinal nerve fiber layer.  These myelinated patches exhibit distinct borders and typically do not obscure underlying retinal vessels.  Differential diagnosis includes retinal exudates, cotton wool spots, and other retinal opacities.  Optical coherence tomography (OCT) may be utilized to confirm the diagnosis of MRNF and demonstrate thickening of the retinal nerve fiber layer in the affected area.  Visual field testing may reveal corresponding defects consistent with the location and extent of myelination.  Given the benign and typically nonprogressive nature of MRNF, no specific treatment is indicated. Patient education regarding the nature of the condition and prognosis was provided.  Follow-up eye examinations are recommended to monitor for any changes and differentiate MRNF from other potentially progressive retinal pathologies.  ICD-10 code H35.021, Myelinated retinal nerve fibers, will be used for billing and coding purposes.  This documentation serves as a record of the patient's clinical presentation, diagnosis, and management plan within the electronic health record.