A case of sudden painless loss of vision with partial spontaneous recovery

Abstract

Case Profile A 47-year-old female came with a history of loss of vision in the right eye since 4 days. It was sudden in onset and painless. She gave history of consulting an ophthalmologist within 12 h of visual loss and was treated with ocular massage and systemic acetazolamide. Within 24 h of initiation of treatment, the temporal half of vision was spontaneously restored partially. Anterior segment examination was unremarkable in both eyes. Visual acuity by Snellen's chart at presentation to us in right eye was 6/18, N10 and intraocular pressure by applanation tonometry was 12 mmHg. Right eye fundus picture is given below [Figures 1 and 2]. Optical coherence tomography (OCT) of the macula [Figure 3] and fundus fluorescein angiography was performed to confirm the diagnosis. Figure 1 Dilated fundus photograph of right eye Figure 2 Photo of optic disc of the right eye Figure 3 Optical coherence tomography of right eye Questions Describe the fundus picture in Figures 1 and 2. Describe OCT changes in [Figure 3] What is the most likely diagnosis? What is the most common causative factor leading to it? What could be the reason for the partial spontaneous recovery of the temporal field of vision? What systemic investigations would you like to perform in such a case? For answers please see page 71.