UCONN Emergency Medicine Interest Group

Posts Tagged ‘ophthalmology’

Ultrasound Case #2

In RADIOLOGY on May 29, 2011 at 9:21 AM

Syndicated from the UCONN EM Residency website; credit to Dr. Russell and Dr. Kleinberg for cases and images.

CC: Vision loss in right eye

HPI: 59 yo male with PMH poorly controlled diabetes presents with painless vision loss in the right eye.  Patient initially noticed blurry vision in the periphery of his right eye for the past week and an increase in the number of floaters in the eye.  Today it was almost like a black curtain was coming down in the eye so he came to the ED for an evaluation.  He denies any history of trauma, redness or foreign body sensation.

SH: Smokes 1ppd for the past 40 years, no IVDU or alcohol use.

FH: Diabetes.

PE: Afebrile, VSS.  Eyes: EOMI, PERRLA, no evidence of globe trauma.  Fundoscopic exam: no obvious abnormality.  Visual acuity: patient not able to see light or moving objects in right eye, left 20/50.  Intraocular pressure, 15 bilaterally.  Visual fields: not able to see out of right eye, normal in left eye. SLE: anterior chamber appears normal, no foreign bodies or corneal ulcerations appreciated.

Bedside U/S (see beginning of post for 1st still image): click for video.

What is the diagnosis? (click below to see the answer below the fold)

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