History/Chief Complaint
- A 60-year-old Hispanic female presented with a sudden, painless loss of vision in her left eye upon awakening. She had no other common neurological complaints. Her general health history revealed systemic hypertension, treated with Benicar.
Clinical Findings
- BCVA 20/25 OD 20/30 OS.
- Ta = 28 OD 27 OS.
- Gonioscopy open grade 2 OU.
- Pupils 2+ Relative Afferent Pupillary Defect (RAPD) OS.
- Motility: full with no pain on eye movements reported.
- Fundus exam – slight disc blur left eye with spontaneous venous pulsation OU.
Diagnosis
- Optic Neuropathy OS of unknown etiology.
Disposition
- Referral to her internist for comprehensive workup.
- Follow-up several days later for additional tests of optic nerve function and structure.
- MRI of brain and orbits ordered.