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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