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JAMA Ophthalmology Clinical Challenge
September 2017

A Diver With Double Vision

Author Affiliations
  • 1Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota
  • 2Department of Neurology, Mayo Clinic, Rochester, Minnesota
JAMA Ophthalmol. 2017;135(9):1001-1002. doi:10.1001/jamaophthalmol.2017.0660

A 39-year-old man with a history of Osler-Weber-Rendu syndrome presented with double vision after scuba diving. When he descended to 35 ft during his dive, the patient experienced blurred vision in the right eye and sharp pain in the right temporal area. At 50 ft of depth, vision in the right eye went completely black. He ascended back to the surface at an appropriate speed and his vision recovered, but he was left with a mild residual blur. This was associated with a pain and pressure sensation in the right eye lasting 30 minutes and noticeable bruising on the right upper eyelid. After this episode, he noticed constant, binocular, diagonal diplopia in all gazes that was worse in upgaze.

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