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JAMA Ophthalmology Clinical Challenge
January 2015

An Adolescent With a Swollen Nerve

Author Affiliations
  • 1Department of Ophthalmology, University of California, San Francisco
JAMA Ophthalmol. 2015;133(1):97-98. doi:10.1001/jamaophthalmol.2014.4461

A previously healthy 13-year-old boy presented to an optometrist 2 days after the onset of blurred vision in his left eye. His best-corrected visual acuity was 20/20 OD and 20/200 OS. Findings on pupillary, motility, and slitlamp examination of the anterior segment were unremarkable. Findings on dilated fundus examination of the right eye were normal. Figure 1A depicts the fundus findings in the left eye. The patient’s history was negative for travel, recent vaccinations, or systemic illnesses. He denied having fever, nausea, headache, or other influenzalike symptoms.