Quiz: Pain, Redness & Headache

A 60-year-old black male presents with a three-day history of right eye pain, redness, right temporal headache and epiphora for the past 3 days. He denies any history of recent eye trauma or eye surgery. He has a history of poor vision in the right eye for many years. Past ocular history is significant for cataract surgery with IOL in the left eye in the 1990s. He also has a history of diabetes, hypertension and hyperlipidemia. Examination reveals hand motion vision in the right eye and 20/25 in the left eye. Intraocular pressures are 63 mmHg in the right eye and 16 mmHg in the left eye. There is no relative afferent pupillary defect (RAPD). Slit lamp examination of the right eye reveals 2+ conjunctival injection, diffuse microcystic edema, 1+ anterior chamber cell and 2+ flare with visible iridescent particles, a minimally reactive iris and a dense white cataract with irregular anterior capsule. The angle appears open on gonioscopy but visualization is limited by the hazy cornea. There is no view to the fundus; however, B-scan shows a posterior vitreous detachment.



Last Updated: October 31, 2022

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