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JAMA Neurology Clinical Challenge
May 28, 2021

Sequential Bilateral Vision Loss in a Woman With Scalp Tenderness and Jaw Claudication

Author Affiliations
  • 1Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago
JAMA Neurol. 2021;78(7):878-879. doi:10.1001/jamaneurol.2021.0757

A 67-year-old woman with fibromyalgia presented with sequential bilateral vision loss. Vision decreased suddenly in the right eye 3 to 4 weeks prior and in the left eye 5 days prior. She reported left-sided scalp tenderness; jaw claudication; neck, shoulder, and low back pain; and a recent 6.8-kilogram weight loss. Visual acuity was 20/200 in the right eye (OD) and hand motion in the left eye (OS). She had a left relative afferent pupillary defect, moderate dry-eye syndrome, and mild cataracts. The right optic nerve had a cup-disc ratio of 0.55 with temporal pallor and mild optic disc edema, and the left nerve had a cup-disc ratio of 0.50 with mild edema without pallor.

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