Quiz: Motor Vehicle Accident

You are called to the emergency room to evaluate a patient who had a mild motor vehicle accident. Other than neck pain she has no complaints. Her pupils react symmetrically to light and the rest of the examination is normal except for what is shown in the photograph below.  

Quiz: Decreasing Vision Over Several Months

A 56-year-old woman notes decreasing vision in the left eye over several months. Visual acuity is 20/20 (6/6) right eye, 20/60 (6/18) left eye and there is a left relative afferent pupillary defect. Her fundus is shown below.

Quiz: Difficulty Seeing at Night

A 21-year-old female presented for a routine exam with complaints of difficulty seeing while driving at night. Past ocular, medical and social history were unremarkable with the exception of oral contraceptive use. Family ocular history was notable only for senile macular degeneration in a maternal grandmother and moderate refractive errors in several family members. Uncorrected … Read more

Quiz: Worsening Vision Over One Week

A 23-year-old man notes worsening vision in the left eye over one week. Visual acuity is 20/20 (6/6) right eye and 20/200 (6/60) left eye. There is a left relative afferent pupillary defect. The left optic disc is shown.

Quiz: Pain with Chewing

A 73-year-old woman has pain with chewing and headaches. She lost vision suddenly in the eye shown. There is a relative afferent pupillary defect.

Quiz: Monocular Elevation Deficiency

This 15-year-old girl presented with ptosis and inability to elevate the right eye past the horizontal median noted since early childhood, possibly since birth. Abduction and adduction of both eyes are normal.

Quiz: “Blotchy Spots”

This 15-year old female presented to the Emergency Department with fatigue for one month. She also complains of nausea and vomiting for the past several days with headaches and “blotchy spots” in her vision. The ED medical staff noted white rings around her eyes and therefore consulted ophthalmology.

Quiz: Infant with Abnormal Red Reflex

A 17-month-old male born at full-term with no significant past medical history presented for examination after the family noted strabismus with the left eye deviating inward. An abnormal red reflex was noted and these photographs represent the ophthalmic examination of the left eye. The right eye was normal.      

Quiz: Brief Episodes of Visual Blur

A 24-year-old obese woman complains of brief episodes of visual blur in the right eye. She is having headaches. Visual acuity is 20/20 OU (6/6 OU) and there is no relative afferent pupillary defect. Visual fields are full to confrontation and exam is otherwise normal except for the fundus appearance.