When Colour Faded First

neuro ophthalmology
Patient Demographics
Age: 44 years
Gender: Male
History of Presenting Complaint

Gradual, progressive blurring and dimming of vision in the left eye over several months. Specifically reports that colours appear washed out and less vivid in the left eye compared to the right. No pain, no diplopia, no headache volunteered.

Past Medical History
  • No significant past medical history reported
Examination Findings

Visual Acuity

OD: 6/6. OS: 6/60

Pupils

Left relative afferent pupillary defect (RAPD) present

Extraocular Movements

Full both eyes

Anterior Segment

Unremarkable bilaterally

Posterior Segment

Optic discs — see OCT. Colour vision (Ishihara) OS: 1/15 (severely reduced). Visual field: left inferior altitudinal field loss.

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Automated visual field testing
MRI brain and pituitary with contrast
OCT optic disc / RNFL
Pituitary hormone panel
Temporal artery biopsy

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