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JAMA Ophthalmology Clinical Challenge
July 2017

Acute and Painless Monocular Vision Loss in a Human Immunodeficiency Virus-Positive Man

Author Affiliations
  • 1Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
  • 2University of Ottawa Eye Institute, Ottawa, Ontario, Canada
JAMA Ophthalmol. 2017;135(7):811-812. doi:10.1001/jamaophthalmol.2016.5679

A man in his 40s presented with central vision loss in his right eye of 1-week duration. There were no associated feelings of pain, flashes, or floaters. A review of his systems was significant for bilateral lower leg swelling, a rash of the torso, painful “bumps” on his neck, reduced hearing abilities, and tinnitus.

His medical history was significant for human immunodeficiency virus, controlled with antiretroviral therapy (Strilbild; Gilead Sciences Inc). His cluster of differentiation 4 count was 600, and his viral load was undetectable. His ocular history was unremarkable. He was homosexual, did not smoke, and denied intravenous drug use.

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