Author: Jagruti Godhaniya / Editor: Fiona Mendes, Yasmin Sultan / Codes: IC2, OptC5, OptP3, OptP4, SLO1, SLO2Published: 15/03/2023

An 86-year-old male attends the emergency department (ED) complaining of a right red eye with extreme pain. The pain worsens with bright lights and he has noticed reduced vision. His symptoms started three days ago. He does not wear contact lens.

Previous medical history:

  • Addison disease for which he takes lifelong prednisolone. 
  • Hypertension
  • Type 2 Diabetes for which he takes metformin

Previous surgical history:

  • Right eye cataract surgery 2 weeks ago
  • Left knee replacement 20 years ago.

Observations:

Oxygen saturations: 99% on air
Respiratory rate 18 breaths per minute
Blood pressure 135/75 mmHg
Heart rate 72 beats per minute
Temperature: 36.5 degrees Celsius

Visual acuity of the right eye is hand movement and 6/6 in the left eye.  

Slit lamp examination reveals the following:

Fig.1 via Flickr

On fundoscopy, there is white debris in the vitreous obscuring the view of the retina.

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