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JAMA Ophthalmology Clinical Challenge
April 2013

Woman With Sudden Loss of Vision—Quiz Case

Author Affiliations


Author Affiliations: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami, Florida.

JAMA Ophthalmol. 2013;131(4):531-532. doi:10.1001/jamaophthalmol.2013.304a

A 28-year-old woman of Irish descent with a history of seizures and high myopia with astigmatism developed sudden loss of vision in her right eye and headache the night before presentation. She reported no history of trauma. Her cardiac, social, and family histories were unremarkable. Best-corrected visual acuity was 20/300 OD and 20/40 OS, with intraocular pressures of 45 mm Hg on the right and 7 mm Hg on the left. On examination of the right eye, an anterior and inferior subluxation of the lens was noted, with pupillary block and corneal edema obscuring the view of the posterior segment (Figure 1 and Figure 2). Examination of the left eye revealed an inferior lens subluxation with broken zonular fibers superiorly and an unremarkable fun-dus (Figure 3). Physical examination revealed normal length digits, with no evidence of hyperextensibility, ardiac murmurs, or rash.

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