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JAMA Ophthalmology Clinical Challenge
September 5, 2019

A Woman With Bilateral Retinal Detachments

Author Affiliations
  • 1Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago
JAMA Ophthalmol. Published online September 5, 2019. doi:10.1001/jamaophthalmol.2019.3086

A 33-year-old otherwise healthy black woman presented to the emergency department for evaluation of blurry vision in both eyes. She had no relevant medical, family, or ocular history. There was no history of trauma or ocular surgery. One month prior to presentation, she had developed fevers, chills, and coughing. After several days, she had developed redness, pain, photophobia, and blurry vision in her left eye, and she had subsequently developed similar symptoms in her right eye. On presentation, her visual acuity was counting fingers OU. Intraocular pressures were 14 mm Hg OU. A slitlamp examination revealed mild conjunctival redness, 2+ anterior chamber cell, and flare in both eyes, as well as mild posterior synechiae. The cornea was clear without keratic precipitates, and there were no iris nodules. Pigment was present on the anterior lens capsule. A fundus examination demonstrated a moderate amount of vitreous cell, hyperemia and edema of the optic disc, and retinal detachments in both eyes (Figure). The detachments were inferior and shifted with the patient’s head position, suggesting serous detachments. Findings were similar bilaterally. A B-scan ultrasonographic test demonstrated bullous retinal detachments and diffusely thickened choroid.

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