Grand Rounds - Vision is counting fingers at 5ft, both eyes

[Richard_Hom]

Brief History
A 51 year old male presents for an examination c/o blurry vision in either eye. Best vision is CF 5 feet in either eye. No pain. No diplopia, no LOC, no vomiting, no dizziness.

Discuss the following:
What lab tests?
What imaging?
Tentative or differential diagnoses?

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[TAL]

FPG? HbA1C? Do you have access to GDx? Perform FA.

severe NPDR? Diabetic maculopathy?

 

[Richard_Hom]

FPG? HbA1C? Do you have access to GDx? Perform FA.

severe NPDR? Diabetic maculopathy?

Thanks for your post.

1. Why a FPG (fasting postprandial glucose) ?
2. Why a GDX?

 

[optcom]

where is the pix of the right eye?
Bilateral ONH edema or just OS? increased intracranial pressure vs optic neuropathy?
Lab tests,
IVFA
CBC w. differential
FTA-ABS
HbA1c
Esr
CT of the orbit
Q: any c/f in A/C?

 

[Richard_Hom]

where is the pix of the right eye?
Bilateral ONH edema or just OS? increased intracranial pressure vs optic neuropathy?
Lab tests,
IVFA
CBC w. differential
FTA-ABS
HbA1c
Esr
CT of the orbit
Q: any c/f in A/C?

1.Quiet anterior chamber
2. No afferent pupillary defect
3. RBS 552 and glycohemoglobin 15.3%.

Other tests were ok.

Thanks,
Richard

 

[Andrew_Doan]

1.Quiet anterior chamber
2. No afferent pupillary defect
3. RBS 552 and glycohemoglobin 15.3%.

Other tests were ok.

Thanks,
Richard

Appears that the patient has diabietic papillitis with severe DM retinopathy. With the presence of bilateral disc edema and flame hemorrhages, the BP should be checked in the office: http://webeye.ophth.uiowa.edu/eyeforum/case17.htm