Flashes and Shadows in a Middle-Aged Woman
retinal vascular
Patient Demographics
Age: 46 years
Gender: Female
Occupation: Marketing Manager
History of Presenting Complaint
Multiple episodes of transient flashes of light in the right eye over the past 3 months, each lasting 10-15 seconds. Episodes are followed by temporary dark spots in the central vision that resolve after 20-30 minutes. No headache, nausea, or neurological symptoms accompanying the visual disturbances.
Past Medical History
- Recent episodes of shortness of breath on exertion
- Palpitations noted over the past 6 months
- No previous eye problems
- No family history of cardiac disease
Examination Findings
Visual Acuity
OD: 6/9, OS: 6/6
Pupils
Equal, reactive, no RAPD
Extraocular Movements
Full and pain-free in both eyes
Anterior Segment
Both eyes: Clear cornea, deep anterior chamber, no inflammation
Posterior Segment
OD: Multiple cotton wool spots and small retinal hemorrhages in the posterior pole. OS: Normal retinal appearance with clear optic disc
Intraocular Pressure
OD: 15mmHg, OS: 14mmHg
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Fundus photography
OCT macula
Echocardiogram
MRI brain
Fluorescein angiography
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