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JAMA Ophthalmology Clinical Challenge
November 2016

Reduced Visual Acuity Following Kidney Stone Extraction

Author Affiliations
  • 1Duke Eye Center, Duke University Medical Center, Durham, North Carolina
  • 2Duke University School of Medicine, Durham, North Carolina
JAMA Ophthalmol. 2016;134(11):1321-1322. doi:10.1001/jamaophthalmol.2016.2173

A man in his 60s presented with subacute vision loss in his right eye for the prior 3 weeks. His medical history was significant for diabetes without retinopathy and radial keratotomy in both eyes for moderate myopia. The patient had undergone 2 ureterorenoscopies over a 2-week period with laser fragmentation for nephrolithiasis. A ureteral stent was placed followed by systemic ciprofloxacin. The patient’s urinary symptoms subsequently improved. In the ensuing days to weeks after these urologic procedures, the patient reported fever, weakness, and decreased appetite, which resolved spontaneously after several days but resulted in persistent weight loss of approximately 15 lb. Three months following this episode, visual symptoms developed.

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