Article

Patient has decreased vision, photophobia

A 26-year-old African American female presented to the Bascom Palmer Eye Institute emergency room with complaints of progressively decreasing vision in both eyes over the past 2 weeks associated with numbness on the right side of her face and mouth. She also had symptoms of light sensitivity but denied flashes, floaters, or other ocular symptoms. She denied any other recent illnesses, drug usage, exposure to parasites, infections, or risk factors for HIV.

Key Points

Examination

Fundoscopic exam of both eyes (Figure 1) was significant for normal-appearing optic discs with normal borders and no evidence of papilledema. Multiple cotton-wool lesions surrounded the optic discs of both eyes, with infiltration of the fovea on the left. The lesions were flat and located within the retinal nerve fiber layer.

Differential diagnosis

The differential diagnosis includes retinal vasculitis, hypertensive retinopathy, giant cell arteritis, Purtscher's retinopathy, optic neuritis, HIV retinopathy, sarcoidosis, syphilitic chorioretinopathy, and tuberculosis.

Newsletter

Don’t miss out—get Ophthalmology Times updates on the latest clinical advancements and expert interviews, straight to your inbox.

Related Videos
(Image credit: Ophthalmology Times) ASCRS 2025: Jason Bacharach, MD, on early-onset efficacy with perfluorohexyloctane in dry eye
© 2025 MJH Life Sciences

All rights reserved.