Eyeexam saves a life. | Figure 1
Andreas94
Optometrist
Case Report
Follow up of the patient with Central Retinal Vein Occlusion. He was taken directly to hospital where my diagnosis was confirmed. A blood pressure of 270 over 160 was found. He was kept in intensive care for 3 days and observed for a few more days. If he hadn't come for a routine eye exam, he would probably suffer from a massive stroke within a day or two. This happened in rural Norway, far from the hospital.
A secondary diagnosis of glaucoma was also confirmed. He will get a new check with an ophthalmologist in about one month when BP is under control and stable.
Similar Cases
Patient's Details:
A male patient 55 years old, average body weight complaining recurrent attacks of sudden syncopes starting by dizziness and sweating that progressed rapidly to fainting.- Transferred to Hospital
Blood pressure measured and found low, improved with saline solution. - Normal CBC
- Normal ECHO
- Normal CT brain and neurological examination
- Diagnosis: Possible differential diagnosis to consider
- Transferred to Hospital
Patient's Details:
Patient came in with severe thrombocytopenia of unknown origin.- GCS 15 for 7-8 days.
- Day 7 had LP.
- Day 8: Slowly widening pulse pressures, sudden increased bleeding from LP site, then acute hypertension, change in LOC, dropped to GCS 3.
- Diagnosis: CT revealed this.
Patient's Details:
88 YO M called for unresponsive and vomiting.- Past medical hx of CVA and currently on warfarin.
- Last seen normal around 1100-1130, called around 1300.
- Completely unresponsive to painful stimuli; last BP at the hospital read 263/139.
- Action: RSIed once at the hospital and taken to CT.
- Plan: Keep his pressure around 180 systolic to prevent cutting off complete blood supply to his brain, reverse the warfarin, and hope he stops bleeding.
Patient's Details:
Patient admitted to the hospital with leg edema and difficulty in breathing.- Question: What’s your diagnosis? What necessary tests will you propose to get to the diagnosis?
Patient's Details:
A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis.- History of: Hypertension, long-term smoking, sedentary lifestyle.
- Physical Examination: Bibasilar crackles noted on lung auscultation.
- Action: ECG performed, promptly referred to the emergency department.
Patient's Details:
A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back.- Exposure: No recent travel or exposure to new environments.
- Cares for: Small kennel with dogs rescued from the streets.
- Physical Examination: Multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and left gluteal area.
Patient's Details:
A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days.- Physical Examination: Multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.
Patient's Details:
Patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family.- Question: Are there any features in this EKG that would warrant further work-up or is this just a pediatric EKG?
Conclusion
- Eye exams are crucial in detecting otherwise hidden serious conditions that might lead to life-threatening outcomes.