July 25, 2012 by EmerJencyWEBB
A lady in her early 60’s came to the ED and was quickly taken back to the eye room with a chief complaint of decreased vision. After taking the history, it quickly became apparent that her symptoms did not represent true vision loss. After a work-out session, the patient reported she suddenly began seeing floaters and flashes of light in the right eye. She also said, “It looks like a curtain is waving back and forth in my peripheral vision”. This only affected her right eye, and it was painless.
She was otherwise healthy without major medical problems, nor was she on any medications. Her exam was also unremarkable. She had mild dec temporal visual field, but had 20/20 vision corrected bilaterally and on my limited fundoscopic exam on an undilated pupil, I could see no major abnormality. Weird, but again the exam was limited.
After hearing her story, I rang up the Ophthalmologist on call. “I have a lady down here who I think has a retinal detachment”. Classic history…it was like she read the book. She even used the word curtain!
BUT… Retinal detachment, it was not…
In part 2, I’ll tell you what she actually had, the treatment, and provide some images.
Disclaimer: The Case Report series employs no real life patient data or identifiers. All case descriptions are loosely based on an amalgam of cases encountered in clinical practice, but not on any one case in particular. The primary goal is to set the stage for a clinical question to be answered in sequence.