A 21-year-old male was referred for evaluation of severe, painless, bilateral vision loss. Four months prior to presentation, the patient had normal uncorrected vision and passed his driving license test. The patient could not recall a specific moment of worsening and he was unsure whether one eye was affected prior to the other or if there was synchronous involvement. Ocular Exam Visual acuity (best-corrected): Right eye (OD): 20/160 Left eye (OS): 10/200 Intraocular pressure OD: 14 mmHg OS: 17 mmHg Pupils: No relative afferent pupillary defect (RAPD) OD: 6 mm (Dark), 4 mm (Light), brisk OS: 6 mm (Dark), 4 mm (Light), brisk Confrontation visual fields with red targets OD: Central scotoma within the central 10 degrees OS: Central scotoma with temporal field loss Motility Normal in all fields of gaze External examination Moderate acne Slit lamp examination Lid/Lashes: Normal, both eyes (OU) Conjunctiva/Sclera: Clear and quiet OU Cornea: Clear OU Anterior chamber: Deep and quiet OU Iris: Normal architecture OU Lens: Clear OU Vitreous: Normal OU Dilated fundus examination
Posted on: Thu, 04 Sep 2014 07:46:15 +0000
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