A 64-year-old man presented with vision loss in the right ey | Figure 1
Cleveland_Clinic
A 64-year-old man presented with vision loss in the right eye that had progressed over the course of the previous four weeks.
His visual acuity was reduced to hand motion in the right eye and was 20/20 in the left eye. There was no history of trauma.
Wide-field fundus photography (Figure A) showed a giant retinal tear of 6 clock hours. In addition, half of the retina folded on itself, and there was bare choroid superotemporally and a horseshoe tear at 1:30 o'clock. We performed vertical spectral-domain optical coherence tomography, which showed detached macula with the foveal center folded over the inferior retina.
We decided to perform pars plana vitrectomy with silicone oil injection.
At his six-week postoperative visit, the patient’s visual acuity was 20/400 with pinhole. Postoperative fundus photography (Figure B) demonstrated a reattached retina. The vertical optical coherence tomography (OCT) showed silicone oil reflection and ellipsoid zone (arrow) atrophy (between arrowheads) in the foveal center.
25 years old female, with a history of left-eye complete amaurosis due to retinal detachment at 4, presents to the office with a 2 weeks complain of sudden visual acuity loss, lasting 2-3 hours, unprovoked, associated to global cephalea and retroocular pain. Physical exploration is unremarkable. She has a negative antiphospholipid syndrome profile and a normal eye fundus. We ordered an MRI in order to rule out multiple sclerosis. Any other suggestion regarding a possible etiology?
39 YO M Caucasian, comes to our attention referring visual loss in his right eye field after a drinking night with friends. Negates drug use, visual acuity was perfect, IOP 16mmHg OO, eye fundus without any sort of alteration. In the pics the results of the computerized visual field show a right inferior homonymous quadrantanopia. The patient was sent to neurological consult.
Where could be the lesion localized? Possible causes?
A 50-year-old myopic diabetic man presents with sudden loss of vision in his right eye over the last one day. He describes new flashing lights (photopsia) in the right eye over the last four days with floaters in the same eye. There is no pain. The visual loss started in the bottom of his visual field, but has progressed to include most of his vision. His diabetes is well controlled, and he has no other medical problems. His pupils react normally. His visual acuity is 6/60 in the right eye and 6/6 in the left.
What is the most likely diagnosis?
A. Proliferative diabetic retinopathy
B. Optic neuritis
C. Retinal detachment
D. Anterior uveitis
E. Corneal abrasion
Question from ClinicalKey Student.
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. He had a history of hypertension, long-term smoking, and a sedentary lifestyle. On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.
A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets. Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.
A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.
Patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this ekg that would warrant further work-up or is this just a pediatric ekg?