Approach to acute vision loss Quiz: Ace Your Exams
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A 60-year-old man presents to the emergency department for evaluation of complete loss of vision in the right eye. Two days ago, he had a similar episode of complete vision loss in the right eye that lasted a few minutes and then resolved completely. He currently has no eye pain. Past medical history is significant for hypertension and hyperlipidemia. Medications include lisinopril and simvastatin. He smokes two packs of cigarettes per day. Temperature is 37.0°C (98.6°F), pulse is 80/min, respirations are 16/min, and blood pressure is 135/85 mmHg. Body mass index (BMI) is 30 kg/m2. There is significant vision loss in the right eye with only hand motions seen in the temporal region. On exam, the right pupil is non-reactive. There is no conjunctival injection or eye discharge of either eye. Extraocular eye movements are intact. Fundoscopy reveals ischemic retinal whitening in the right eye, with pallor of the retinal arteries and a “cherry red spot” in the fovea. Which of the following is most likely to be associated with these findings?
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