The Cardiac Patient's Vanishing Vision

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

Sudden-onset visual field loss. Patient describes loss of vision in part of the visual field. No eye pain or headache reported. The patient was found to have viral cardiomyopathy on echocardiography performed as part of the stroke workup. Visual acuity was preserved bilaterally at 6/6. Pupils were equal and reactive with no relative afferent pupillary defect.

Past Medical History
  • Viral cardiomyopathy
  • On anticoagulation therapy (warfarin and clexane)
Examination Findings

Visual Acuity

OD: 6/6, OS: 6/6

Pupils

Equal and reactive, no relative afferent pupillary defect (RAPD)

Extraocular Movements

Not specifically documented

Anterior Segment

No remarkable findings

Posterior Segment

Fundus examination unremarkable bilaterally

Intraocular Pressure

Not documented

Which investigations would you choose?
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Automated perimetry (visual field testing)
OCT retinal nerve fibre layer
MRI brain
Fluorescein angiography
Echocardiography

0 of 3 investigations selected

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