CME: Patient with vitritis has sudden loss of vision in one eye

A 58-year-old Caucasian woman presented to the Bascom Palmer Eye Institute Emergency Department complaining of sudden loss of vision in the right eye 1 day prior. She denied pain or trauma to the right eye. Medical history was significant for poorly controlled type 2 diabetes mellitus, hypertension, hypercholesterolemia, and obesity.

A 58-year-old Caucasian woman presented to the Bascom Palmer Eye Institute Emergency Department complaining of sudden loss of vision in the right eye 1 day prior. She denied pain or trauma to the right eye.

Ocular history was significant for trauma to the left eye sustained during a motor vehicle accident 14 years prior. Medical history was significant for poorly controlled type 2 diabetes mellitus, hypertension, hypercholesterolemia, and obesity. Review of systems was negative for any recent illness, fever, or headache.

Examination

Differential diagnosis

Inflammatory and connective tissue causes must be considered, such as sympathetic ophthalmia (especially given this patient's history of trauma to the fellow eye), pars planitis, sarcoidosis, or Behçet's disease. Finally, one must consider neoplastic causes such as primary intraocular lymphoma, which may masquerade as a variety of infectious or inflammatory conditions.

Clinical course