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Here you’ll find interesting cases of eye conditions along with news and developments in the ophthalmology world.

Cases are presented as an initial image with history and examination. Health practitioners are encouraged to deduce the condition, before further investigations, diagnosis and management are presented.

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Colour fundus photography of the left eye shows four quadrant intraretinal haemorrhages and engorgement of the retinal veins. There is a patch of white retina adjacent to the optic nerve.

Case 3

Figure 1. Colour fundus photography of the left eye shows four quadrant intraretinal haemorrhages and engorgement of the retinal veins. There is a patch of white retina adjacent to the optic nerve.

Author: Michael Chilov     Editor: Adrian Fung

A 37-year-old lady was referred with acute painless left vision loss

Case history

A 37-year-old female student from Germany presented to her optometrist after waking with vision loss in her left eye. There was no obvious precipitant. The optometrist noted widespread intraretinal haemorrhages and an area of pale retina and referred her urgently for further opinion and management.

Past ophthalmic history was unremarkable. Past medical history included a 20 pack-year history of smoking. There was no history of hypertension, diabetes or clotting disorders. She was not taking the oral contraceptive pill.

Visual acuities were 6/5 in the right eye (OD) and 6/36 (no improvement with pinhole) in the left eye (OS). Intraocular pressures were 16mmHg (OD) and 17mmHg (OS). There was no relative afferent pupil defect, suggesting normal optic nerve function. In the left eye there were four quadrant dot and blot intraretinal and flame haemorrhages (Figure 1). The retinal veins were dilated and the optic nerve mildly swollen. There was an area of retinal whitening between the optic nerve and fovea. The macula appeared swollen. There were no inflammatory cells, nor evidence of rubeosis. The right fundus was normal.

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