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JAMA Ophthalmology Clinical Challenge
June 18, 2020

Severe Vision Loss in a Man With Heavy Tobacco and Alcohol Consumption

Author Affiliations
  • 1Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
  • 2Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
  • 3Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
JAMA Ophthalmol. Published online June 18, 2020. doi:10.1001/jamaophthalmol.2020.0900

A 44-year-old man presented with a 4-month history of gradual vision loss in both eyes. He had a medical history of hypertension, anxiety, and posttraumatic stress disorder, for which he took amlodipine, lorazepam, citalopram, and quetiapine. He smoked 1.5 packs of cigarettes per day for the past 30 years and had a history of substantial alcohol use, drinking 2 to 3 L of wine per day. Because of excessive alcohol intake, he only ate 1 meal per day. His family history was unremarkable for optic nerve conditions or unexplained blindness.

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