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JAMA Ophthalmology Clinical Challenge
July 25, 2019

Bilateral Loss of Vision a Few Hours After a Motor Vehicle Crash

Author Affiliations
  • 1Departement of Ophthalmology, University Hospitals of Geneva, Geneva, Switzerland
JAMA Ophthalmol. 2019;137(9):1080-1081. doi:10.1001/jamaophthalmol.2019.2674

A 74-year-old woman was referred for bilateral blurry vision occurring 2 hours after a car crash. At the moment of impact, she was wearing her seat belt, the airbag deployed, and an intense flexion-extension head movement occurred.

Best-corrected visual acuity was 20/125 OD and 20/63 OS. Intraocular pressure was 19 mm Hg OD and 20 mm Hg OS. Slitlamp examination revealed no palpebral hematoma, and the anterior segment was found to be normal. On the fundus bilaterally, we only noted an alteration of the foveal reflection, with neither retinae commotio nor hemorrhages. Macular optical coherence tomography (OCT) showed bilateral macular edema with cystoid abnormalities (Figure 1). An epiretinal membrane also was noted in the left eye (Figure 1B).