Author: Helena Fawdry / Editor: Sarah Edwards / Codes: OptP5, SLO1, SLO2 / Published: 20/01/2022
A 35-year-old female presents to the emergency department complaining of several episodes of transient binocular vision loss on bending down and on coughing over the last few weeks, the most recent of which occurred 1 hour ago. These last several seconds before resolving spontaneously. She also reports generalised early morning headaches occurring daily for the last 6 months, with associated pulsatile tinnitus.
She is not taking any regular medications. Her father had a posterior cerebrovascular accident (CVA) aged 65 years old.
Visual acuity assessment is completed using a Snellen chart – her visual acuity is 6/6 in both eyes, Intraocular pressure (IOP) is 14 mmHg right eye and 12mmHg left eye.
Her BP is 135/80.
13 responses
very useful
Not a common presentation to ED but an important one not to miss. Getting an early MRI or MR/CT venogram as well as LP could be a challenge unless this diagnosis is suspected
Interesting and very informative case
Time critical diagnosis to save vision
very good case
Usually a diagnosis of exclusion with good learning points. Great post!!
eye opener
an eye opener !
Very good, thanks
diagnosis of exclusion
Diagnosis of exclusion. Hmmm. Great read
Good case .Summerise causes and investigations.
Good case. Thank you