Aubrey R. Tirpack, MD

A 63-year-old man was referred to the New England Eye Center cornea department with a 4-month history of worsening vision in the right eye. The patient reported a 3-year history of right eye injection, which was associated with intermittent surface irritation and itch. He was treated by his local optometrist for presumed dry eye and used artificial tears as needed for symptomatic relief. Over the past few months, however, he noticed a gradual decrease in the vision of the right eye, which prompted a referral to an outside ophthalmologist.

A 27-year-old marketing professional was seen at Tufts Medical Center emergency department with new-onset vision changes in the right eye. She first noted a change in vision approximately 30 hours before while visiting her family in Philadelphia. She described sudden onset of a “dark storm cloud” covering the vision in her right eye. She was seen at a local emergency room and treated for a migraine. When her vision symptoms persisted, she was evaluated by a local ophthalmologist just before her scheduled flight back to Boston. She was urgently referred to the neuro-ophthalmology department at Tufts on landing in Boston.

A 57-year-old man presented to the Lahey Medical Center ophthalmology clinic with a 1-month history of transient blurred vision in both eyes. His medical history was significant for hypertension, diabetes type 2, osteoarthritis, chronic back pain and a cholesteatoma, which was surgically treated with right tympanomastoidectomy 6 weeks before presentation. His ocular history was significant only for mild myopia, for which he was already wearing glasses.

A 7-year-old boy presented to the Tufts Medical Center emergency department with a 2-week history of headache and 1-week history of binocular horizontal diplopia. He had no medical history. His ocular history was significant only for mild myopia for which he was already wearing glasses.

A 76-year-old woman presented to the New England Eye Center with a 3-month history of floaters and blurred vision in her left eye. Her medical history was significant for hypertension, hyperlipidemia, hypothyroidism and recent aortic valve replacement 1 month before onset of visual symptoms. Her ocular history was significant for bilateral cataract extraction with placement of posterior chamber IOLs 5 years before presentation.

A 32-year-old pregnant woman at 31 weeks’ gestational age was referred to the New England Eye Center for a 1-week history of floaters and decreased vision in the left eye. She complained of 1 day of photophobia and left eye pain.

Menino de 7 anos apresentou-se no setor de emergência do Tufts Medical Center com histórico de dor de cabeça há 2 semanas e de diplopia binocular horizontal há 1 semana. Ele não tinha histórico médico. Seu histórico ocular era significativo apenas para uma miopia moderada para a qual ele já utilizava óculos.

Un niño de 7 años de edad acudió al servicio de urgencias del Tufts Medical Center por dolor de cabeza de 2 semanas de evolución y diplopía binocular horizontal de 1 semana de evolución. No tenía antecedentes médicos. Sus antecedentes oculares solo eran relevantes para la miopía leve, motivo por el cual ya usaba anteojos.