Quiz: Vision Loss & Headache

A 50-year-old female presented with a one week history of progressive vision loss, headache, and pain in both eyes. Four days prior to examination she noticed a worsening of the vision loss and was evaluated by a general doctor who gave her some unidentified eye drops which did not help. She then presented to an ophthalmologist for further evaluation and treatment. She has no previous ophthalmic, surgical, or relevant medical history.

Examination:
VA: Hand Movement, both eyes (pinhole)
IOP: 50mmHg, both eyes
External and slit-lamp exam as shown in these photos:

 

 

Last Updated: September 12, 2022

6 thoughts on “Quiz: Vision Loss & Headache”

  1. An anterior chamber paracentesis can be carefully done on the slit lamp for acute pressure drop. One should consider phacoemulsification as soon as inflammation is controlled and the cornea becomes clear. A MGS procedure can be combined with cataract surgery for improved pressure drop.

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  2. Thank a lot cybersight-orbis❤️🔥💯
    My thoughts for question3 of index case-

    ….the question said urgent treatment…
    My humble thoughts are that topical pilocarpine would be ineffective to urgently pull the ischemic/paralysed Iris sphlincters from the angles at intraocular pressure of 50mmHg…

    Thanks again & again Sir!🙏

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