Waking to Half a World
retinal vascular
Patient Demographics
Age: 89 years
Gender: Male
History of Presenting Complaint
Woke with sudden left superior altitudinal visual field loss. No pain or headache.
Past Medical History
- Coronary artery bypass grafting (×2 grafts)
- Femoral artery graft
- Hypertension on antihypertensive medication
- Hyperlipidaemia on cholesterol-lowering medication
- Warfarin anticoagulation therapy
Examination Findings
Visual Acuity
6/6 part in both eyes (right eye normal, left eye 6/6 part despite field loss)
Pupils
Relative afferent pupillary defect (RAPD) present in left eye
Extraocular Movements
Full and normal in both eyes
Anterior Segment
Normal anterior segments bilaterally, no inflammation
Posterior Segment
Right fundus: Normal optic disc, vessels, and macula. Left fundus: Signs consistent with inferior retinal infarction - retinal whitening in inferior arcade distribution, visible embolus at arterial bifurcation, attenuated arterioles in affected area
Intraocular Pressure
Normal bilaterally
Which investigations would you choose?
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Visual field testing
MRI brain
Carotid Doppler ultrasound
OCT macula
Fundus photography
0 of 3 investigations selected
Investigations (Locked)
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