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JAMA Ophthalmology Clinical Challenge
October 5, 2017

Retina Folds and Subretinal Fluid After Bell Palsy

Author Affiliations
  • 1Retina Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston
JAMA Ophthalmol. Published online October 5, 2017. doi:10.1001/jamaophthalmol.2017.2778

A woman in her late 20s presented with blurry vision in both eyes of 2-week duration. Her ocular history included optic neuropathy 5 years prior to presentation. Her medical history included acute lymphocytic leukemia (currently in remission) after an allogenic hematopoetic stem cell transplant. Two months before presentation, she developed Bell palsy on the right side of her face for which she was being treated with oral prednisone; her other medications were oral contraceptives and multivitamins. As her Bell palsy was improving, she noted worsening of her visual acuity. Her best-corrected visual acuity was hand motion OD and 20/400 OS. Tensions were 12 mm Hg bilaterally. A slitlamp examination revealed normal anterior segments in each eye. The vitreous was free of cells in each eye. A dilated ophthalmoscopic examination revealed mild optic nerve pallor (associated with her past episodes of optic neuritis) (Figure). Fluorescein angiography demonstrated no leakage.

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