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JAMA Ophthalmology Clinical Challenge
July 2018

Young Man With Severe Bilateral Papilledema

Author Affiliations
  • 1Medical student, University of Illinois College of Medicine, Chicago
  • 2Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago
JAMA Ophthalmol. 2018;136(7):831-832. doi:10.1001/jamaophthalmol.2017.6652

A man in his mid-20s with severe bilateral papilledema presented to the emergency department with a 6-week history of progressively blurred vision resulting in a near-complete loss of vision. Associated symptoms included transient visual obscurations, glare, photophobia, and “whooshing” in the patient’s ears that occurred in association with elevated blood pressure, although classic pulsatile tinnitus was not present. The patient denied headache, diplopia, nausea, or vomiting. His ocular history was significant for refractive error. His medical history revealed hypertension, systolic heart failure, atrial fibrillation, and end-stage renal disease. The causes of these conditions were unknown.

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