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JAMA Ophthalmology Clinical Challenge
August 13, 2020

Transient Vision Loss in a Healthy Older Woman

Author Affiliations
  • 1Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania
JAMA Ophthalmol. 2020;138(10):1091-1092. doi:10.1001/jamaophthalmol.2020.1421

A 72-year-old White woman, who was experiencing episodes of nontraumatic transient vision loss for 2 weeks, was evaluated by an ophthalmologist. On examination, visual acuity was 20/30 OU. Intraocular pressure (IOP) was 16 mm Hg OD and 41 mm Hg OS. The anterior segment was normal in the right eye. Anterior examination of the left eye revealed 10% hyphema. The patient was prescribed cyclopentolate, 1%, and prednisolone acetate, 1%, to reduce inflammation and lower the IOP in the left eye. Two days later, IOP was 16 mm Hg OD and 10 mm Hg OS. Slitlamp biomicroscopy revealed resolved hyphema and abnormal blood vessels at the superotemporal pupillary margin of the iris, prompting referral for further evaluation.

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    1 Comment for this article
    Gihad El-Nahri, MD | Armed Forces College of Medicine, Egypt
    Nice case. Many of these bleeding episodes are due to NSAID use for various causes. This should be carefully sought in history-taking.