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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 photograph of the right eye shows pallor superior to the fovea extending temporally from the optic disc.

Case 35

Figure 1. Colour fundus photograph of the right eye shows pallor superior to the fovea extending temporally from the optic disc.

Author: Simon Nothling     Editor: Adrian Fung

A 67-year-old male was referred with a 1 day history of painless inferior scotoma in his right vision.

Case history

A 67-year-old man, presented with a 1 day history of a painless, small, inferior scotoma in his right vision. He had no other associated symptoms such as headache, pain, flashes or floaters, jaw claudication, limb weakness, speech disturbance or paraesthesiae. Past medical history included ischaemic heart disease, a triple coronary bypass operation in 2004, gout, hypertension and hypercholesterolaemia. His medications consisted of aspirin, metoprolol and atorvastatin. He quit smoking 10 years ago but drank 4-5 alcoholic drinks per day.

Visual acuities were 6/12-2 pinhole 6/7.5-2 in the right eye, and 6/6-2 in the left. Intraocular pressures were normal at 14mmHg bilaterally. Anterior segment exam was normal bilaterally.

Colour fundus photographs revealed an area of pale, oedematous retina in the right superior macula (Figure 1). The right optic disc and left fundus were normal.

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