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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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A small white lesion is visible just inferior to the left fovea.

Case 47

Figure 1. A small white lesion is visible just inferior to the left fovea.

Author: Simon Nothling     Editor: Adrian Fung

A 42-year-old female presented with a 2-week history of a “blurry spot” in her left vision.

Case history

A 42-year-old female presented with a 2-week history of a small “blurry spot” just above fixation in her left eye. There was no associated photopsiae or floaters, and her right eye was unaffected. There was no pain on eye movements and no other neurological symptoms such as headache or limb pareathesiae. She had suffered from migraines associated with her menstrual cycle but had no other medical conditions. Her only regular medication was Trifeme (levonorgestrel and ethinylestradiol), oral contraceptive pill taken for hormonal regulation for per vaginal bleeding. She did not smoke.

Visual acuities were 6/5 bilaterally with spectacles. Intraocular pressures were 15mmHg in both eyes. Amsler Grid testing revealed a small scotoma just above fixation. Pupillary reflexes, colour vision and red saturation were all normal. Anterior segment examination was normal with no signs of intraocular inflammation. Dilated fundoscopy of the left eye showed a white lesion inferior to the fovea (Figure 1). The right macula and optic nerves were normal.

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