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Woman presents with acute onset monocular visual distortion
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A 27-year-old woman with a history of Crohn’s disease complained of new onset visual distortions, which started 3 days prior. She described seeing a wavy area in the inferotemporal region of her visual field in the left eye. She also felt that colors appeared washed out bilaterally. She denied having similar symptoms in the past.
She did not take any medications. She denied any family history of ocular diseases. She denied smoking, alcohol or illicit drug use.
Examination
On examination, best corrected central visual acuity was 20/20 in both eyes. Pupils were equal and round, without an afferent pupillary defect. Color vision tested by Ishihara plates was full bilaterally. IOP by applanation was 16 mm Hg in both eyes. Visual field testing and extraocular movements were full bilaterally.
Anterior segment exam of both eyes was normal in appearance without any anterior chamber cell or flare. Posterior segment exam showed trace vitreous cells. There was mild retinal venous sheathing focally along the inferior arcade in the left eye and in the mid-periphery in both eyes (Figure 1). There was no significant arteritis.
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Click here to read the full publication exclusive, Grand Rounds at the New England Eye Center, published in Ocular Surgery News U.S. Edition, November 10, 2014.