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Acute painless visual loss

Francesco Pellegrini, Andrew G Lee, Cristina Cercato
A 49-year-old previously healthy woman presented with acute painless visual loss in the right eye, a right relative afferent pupillary defect, and a normal fundus examination. She was diagnosed with retrobulbar "optic neuritis" and given a course of intravenous steroids. Despite treatment, however, she continued to lose vision and serial visual field testing confirmed a junctional scotoma in the fellow eye. Cranial magnetic resonance imaging (MRI) showed a mass at the junction between the right optic nerve and the anterior aspect of the chiasm and a right frontal lesion that proved to be multicentric glioblastoma multiforme...
April 2018: Neuro-ophthalmology
Mark J Elder, John A Rawstron, Michael Davis
INTRODUCTION: Acute retinal artery occlusion (ARAO) is a major cause of sudden, painless visual loss, often leaving no useful vision in the affected eye. Its incidence is cited at 0.85 per 100,000 persons per year but may be higher because of under-reporting. The natural history is difficult to study, but a spontaneous resolution rate of < 1-8% for acute, non-arteritic ARAO has been cited. Occurrence in an only eye is devastating for the patient. There is currently no consensus regarding management of ARAO and little evidence to support any treatment modality...
December 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
Yishay Weill, Koby Brosh, Tamar Levi-Vineberg, Joel Hanhart
PURPOSE: To report a case of acute bacterial endophthalmitis after antivascular endothelial growth factor injection with a rare presentation of vitreous hemorrhage. METHODS: An 84-year-old woman presented with sudden painless vision loss in her left eye, 3 days after intravitreal ranibizumab injection for cystoid macular edema due to neovascular age-related macular degeneration. The patient was otherwise asymptomatic. Dense vitreous hemorrhage was observed. At follow-up the next day, the patient complained on severe left eye pain...
April 2018: International Ophthalmology
Rima M Dafer, John H Pula, Shakeel Chowdhry
Central retinal artery occlusion (CRAO) is a devastating ocular emergency characterized by acute painless visual loss in the ipsilateral eye. We describe the case of acute non-arteritic CRAO associated fusiform internal carotid-ophthalmic artery aneurysm with intraluminal thrombus. Despite the rarity of this condition, we suggest that carotid-ophthalmic artery aneurysm should be included in the differential diagnosis of CRAO.
January 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Dragoş Cătălin Jianu, Silviana Nina Jianu, Ligia Petrica, Andrei Gheorghe Marius Motoc, Traian Flavius Dan, Dorela CodruŢa Lăzureanu, Mihnea Munteanu
Anterior ischemic optic neuropathies (AIONs) represent a segmental infarction of the optic nerve head (ONH) supplied by the posterior ciliary arteries (PCAs). Blood supply blockage can occur with or without arterial inflammation. For this reason, there are two types of AIONs: non-arteritic (NA-AION), and arteritic (A-AION), the latter is almost invariably due to giant cell arteritis (GCA). GCA is a primary vasculitis that predominantly affects extracranial medium-sized arteries, particularly the branches of the external carotid arteries (including superficial temporal arteries - TAs)...
2016: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
Yannis M Paulus, Nicholas J Butler
Posterior ophthalmomyiasis interna is a rare, potentially devastating infestation of the posterior segment by fly larvae. The authors report the first demonstration of spectral-domain optical coherence tomography (SD-OCT) (Spectralis; Heidelberg Engineering, Heidelberg, Germany), wide-field angiography (Optos, Dunfermline, Scotland) and photography, and fundus autofluorescence with temporal progression during a period of 6 months. A 12-year-old white female presented with acute, painless vision loss with hand motions visual acuity...
July 1, 2016: Ophthalmic Surgery, Lasers & Imaging Retina
Fabio Di Censo, Matteo Di Censo, Giorgia Colasante, Marco Bordin, Muna Al Oum
INTRODUCTION: Non-arteritic anterior ischemic optic neuropathy (NAION) is one of the most widespread visually disabling diseases in the middle-aged and elderly population. It typically presents as acute painless unilateral vision loss in patients over 50 years of age. The fellow eye of NAION patients is often sequentially affected. Involvement of the second eye occurs within three years in approximately 45%-50% of patients. Currently there is no generally accepted treatment for NAION but a number of medical and surgical therapies have been proposed...
March 2016: Undersea & Hyperbaric Medicine: Journal of the Undersea and Hyperbaric Medical Society, Inc
Bugra Karasu, Betul Onal Gunay, Gurkan Erdogan, Esra Kardes, Murat Gunay
A 21-year-old girl presented with acute painless vision loss in her right eye. There was no remarkable ocular history and she had a history of anorexia nervosa. At presentation best-corrected visual acuities were counting fingers from 2 meters and 20/20, in the right and left eyes, respectively. Slit lamp examination result was normal. Fundus examination revealed multiple cotton wool spots and intraretinal hemorrhages surrounding the optic disc and macula in the right eye. Fluorescein angiography showed capillary filling defect and leakage from optic disc in the late phase of the angiogram...
2016: Case Reports in Ophthalmological Medicine
Yoshifumi Ikeda, Ichiya Sano, Etsuko Fujihara, Masaki Tanito
A 56-year-old man was referred to our hospital about 48 h after sudden onset of painless central visual loss in his right eye (OD) on a winter morning. He had a more than 25-year history of systemic hypertension and smoking. Funduscopic observation showed striated retinal whitening in the macular region, faint cotton-wool patches around the optic disc, and segmental narrowing of the retinal arteries near the optic disc edge. Based on the pattern of onset and fundus findings, he was diagnosed with vasospastic acute central retinal artery occlusion OD, and a venous drip injection of prostaglandin E1 was started immediately...
September 2015: Case Reports in Ophthalmology
Hana Kolarova, Petra Liskova, Marketa Tesarova, Vendula Kucerova Vidrova, Martin Forgac, Josef Zamecnik, Hana Hansikova, Tomas Honzik
BACKGROUND: Leber hereditary optic neuropathy (LHON) and mitochondrial encephalopathy, myopathy, lactic acidosis and stroke-like episodes (MELAS) syndromes are mitochondrially inherited disorders characterized by acute visual failure and variable multiorgan system presentation, respectively. MATERIALS AND METHODS: A 12-year-old girl with otherwise unremarkable medical history presented with abrupt, painless loss of vision. Over the next few months, she developed moderate sensorineural hearing loss, vertigo, migraines, anhedonia and thyroiditis...
December 2016: Ophthalmic Genetics
Luisa Vieira, Nuno Aguiar Silva, Marco Dutra Medeiros, Rita Flores, Vitor Maduro
Acute lymphoblastic leukemia is a malignant hematopoietic neoplasia, which is rare in adults. Although ocular fundus alterations may be commonly observed in the course of the disease, such alterations are rarely the presenting signs of the disease. Here we describe the case of a patient with painless and progressive loss of visual acuity (right eye, 2/10; left eye, 3/10) developing over two weeks, accompanied by fever and cervical lymphadenopathy. Fundus examination showed bilateral macular serous detachment, which was confirmed by optical coherence tomography...
November 2015: Arquivos Brasileiros de Oftalmologia
Nitin Agarwal, Gaurav Garg, Ajay Kumar Pal, Pranjal Dubey, Akhil Garg, Pooja Dewan
BACKGROUND: Parenteral nutrition (PN) via a central venous catheter is routinely used for surgical patients without a functioning gastrointestinal tract. Complications of PN can be metabolic and thrombotic. Blindness is a rare and unexpected complication. CASE: A young female patient with postcorrosive pyloric stenosis was started on PN through an indwelling central venous catheter. On the sixth day of PN, the patient reported sudden painless bilateral complete loss of vision...
September 2017: JPEN. Journal of Parenteral and Enteral Nutrition
Preeti Patil-Chhablani, Mudit Tyagi, Ramesh Kekunnaya, Raja Narayanan
A 36-year-old woman presented with acute vision loss and was found to have disc oedema and retinitis pigmentosa (RP). She presented with a history of acute, painless vision loss in her left eye over a period of 10 days. Her best-corrected visual acuity was 20/50, N6 in the right eye (OD) and 20/160, N6 in the left eye (OS). She was found to have a swollen optic disc and the examination of her fundus showed changes suggestive of RP. The diagnosis of RP was confirmed by electroretinogram, and after ruling out demyelinating changes in the central nervous system and other possible infectious causes of papillitis, she was treated with intravenous steroids followed by a course of oral steroid therapy...
August 3, 2015: BMJ Case Reports
Abhijit Anand Mohite, Adriana Agius-Fernandez
Chikungunya fever is a vector borne virus that typically causes a self-limiting systemic illness with fever, skin rash and joint aches 2 weeks after infection. We present the case of a 69-year-old woman presenting with an acute unilateral optic neuropathy as a delayed complication of Chikungunya virus (CHIKV) infection contracted during a recent trip to the West Indies. She presented to our ophthalmology department with acute painless visual field loss in the right eye and a recent flu-like illness. She was found to have a right relative afferent pupillary defect (RAPD) with unilateral optic disc swelling...
July 28, 2015: BMJ Case Reports
Zeynep Alkin, Ihsan Yilmaz, Abdullah Ozkaya, Ahmet Taylan Yazici
Non-arteritic anterior ischemic optic neuropathy is a result of an infarction of the small vessel at the anterior portion of the optic disc and causes acute, unilateral, painless visual loss. There is no generally accepted treatment method for this condition but some medical and surgical treatments are recommended. Earlier studies show that visual acuity recovery was better with corticosteroid medication compared to non-treated patients. However corticosteroids may cause side effects such as cataract, increased intraocular pressure and rarely central serous chorioretinopathy...
July 2015: Saudi Journal of Ophthalmology: Official Journal of the Saudi Ophthalmological Society
Carlos Andrade, Olinda Faria, Joana Guimarães
A 69-years-old male patient was treated with amiodarone 200mg/day over the passed two months for atrial fibrillation. He presented a sudden, painless and unilateral visual loss. Ophthalmologic evaluation revealed a bilateral optic disc edema. Neurological examination was otherwise unremarkable. After properly excluding increased intracranial pressure and giant cell arteritis, the main differential diagnosis was between nonarteritic anterior ischemic optic neuropathy and optic neuropathy secondary to amiodarone...
March 2015: Acta Médica Portuguesa
Ziya Ayhan, Gamze Kocaoğlu, Aylin Yaman, Meltem Söylev Bajin, A Osman Saatci
Acute nonarteritic ischemic optic neuropathy (ANAION) is the most common optic neuropathy in the elderly population without a well-established treatment. A 67-year-old man with a sudden painless visual loss in his left eye of one-day duration was diagnosed to have left ANAION. Next day, 2 mg aflibercept injection was injected intravitreally in OS. Visual acuity improved to 7/10 from 1/10 a week after the injection. Mean retinal nerve fiber layer thickness (RNFLT) was reduced to 159,7 μm from 182,4 μm at the first week...
2015: Case Reports in Ophthalmological Medicine
Javier Montero, Enrique Cervera, Paula Palomares, Luis Amselem, Manuel Diaz-Llopis
PURPOSE: The purpose of this study was to report a case of diffuse unilateral retinal detachment as an initial symptom of chronic myelogenous leukemia in a 35-year-old woman. METHODS: This is a case report of a 35-year-old white woman who presented with painless acute visual loss in her left eye. RESULTS: A 35-year-old white woman presented with acute visual loss in her left eye. She had no systemic or ophthalmological medical history. Slit-lamp examination was normal in both eyes...
2010: Retinal Cases & Brief Reports
Verônica Castro Lima, Tiago S Prata, Gennady Landa, Lawrence A Yannuzzi, Richard B Rosen
PURPOSE: To report a case of an idiopathic, unilateral combined central retinal artery and vein occlusion in a young, healthy patient successfully treated with combined intravitreal triamcinolone and bevacizumab injection. METHODS: Interventional case report. A 38-year-old man presented with a 2-hour history of acute painless loss of vision in his right eye. Ophthalmic examination revealed count fingers visual acuity, an afferent pupillary defect, a discreet cherry red spot, optic disk edema, and scattered intraretinal hemorrhages in the right fundus...
2010: Retinal Cases & Brief Reports
Joseph W Sowka, Lori A Vollmer, Michael Au
PURPOSE: The purpose is to report a patient with primary open-angle glaucoma that developed sudden painless unilateral vision loss, a sequential ophthalmoscopic appearance with features of both central retinal artery and later central retinal vein occlusion, and objective visual system dysfunction in the form of a relative afferent pupil defect, who spontaneously recovered vision along with complete resolution of the pupillary defect over several weeks. CASE REPORT: A 50-year-old woman with a long-standing history of glaucoma presented with acute, painless vision loss in one eye, a pallid retina with a cherry red macula, diffuse retinal hemorrhages, and a relative afferent pupil defect...
January 2015: Optometry and Vision Science: Official Publication of the American Academy of Optometry
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