Quiz: Visual Hallucinations

This 89-year-old female presents with a complaint of blurry vision and “seeing multiple colors” in both eyes for the past day.  In addition to the unusual colors, she also reports seeing multiple strange shapes.  She denies any pain, floaters, or previous episodes.  She has a history of neovascular age related macular degeneration (ARMD) in both eyes previously treated with anti-VEGF and steroid injections.  She also has advanced primary open angle glaucoma (POAG) in both eyes for which she is currently taking tafluprost prostaglandin agent glaucoma drops.  She is pseudophakic in both eyes.  Her visual acuity is Count Fingers at 2 feet right eye and 20/400 left eye (her normal baseline).  IOP is 13 mmHg right and 16 mmHg left.  Anterior segment examination is significant for a trace posterior capsular opacification in the right eye.  Dilated fundus examination is significant for 0.95 cupping in both eyes with subretinal fluid in both macula.  The peripheral retina was flat with no detachment or tears in either eye.  A photo of the right eye is shown. What could be happening?

 

Last Updated: September 12, 2022

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