The White Feathery Mystery

retinal developmental
Patient Demographics
Age: 68 years
Gender: Male
History of Presenting Complaint

Episodes of transient visual loss in the right eye. Patient reports occasional brief episodes where vision becomes unclear, lasting a few seconds to minutes before returning to normal.

Past Medical History
  • No significant past medical history
  • No previous eye problems or surgeries
  • No family history of eye disease
  • No systemic medications
Examination Findings

Visual Acuity

OD: 6/6, 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: White feathery streaks extending from optic disc margin into retina, consistent with medullated nerve fibres. Retinal vessels clearly visible coursing through lesions. OS: Similar but less extensive changes

Intraocular Pressure

OD: 14mmHg, OS: 15mmHg

Which investigations would you choose?
Try to decide before revealing the results. You have 2 attempts.
Fundus photography
Fluorescein angiography
OCT retinal nerve fibre layer (RNFL)
Fundus autofluorescence
Visual field testing (Humphrey 24-2)
Carotid duplex ultrasound
MRI brain and MRA

0 of 5 investigations selected

Investigations (Locked)
Complete the investigation selection question above to unlock the full investigation results.
Diagnosis (Locked)
Complete the quiz to reveal the diagnosis.
Management Plan (Locked)
Complete the quiz to reveal the management plan.
Ready to Test Your Knowledge?
Take the interactive quiz for this case to reinforce your learning.

Multiple choice & true/false