Hemorrhagic Occlusive Retinal Vasculitis


History of Present Illness

A 70-year-old man with a history of hypertension, hyperlipidemia, and emphysema presented to an optometrist with sudden loss of vision in the left eye (OS) 2 weeks after seemingly uncomplicated cataract surgery. Uncorrected visual acuity was 20/20 1 day after cataract surgery. The sudden loss of vision occurred over a 10-minute period while eating dinner. He presented to an optometrist, who suspected central retinal vein occlusion and then referred him to the retina clinic for further evaluation.

Exam
OD OS
Visual acuity 20/20 Hand motion
Intraocular pressure (IOP) 12 14
Sclera/conjunctiva White and quiet White and quiet
Cornea Clear Clear
Anterior chamber (AC) Deep and quiet Deep and quiet
Iris Unremarkable Unremarkable
Lens Well-positioned posterior chamber intraocular lens Well-positioned posterior chamber intraocular lens
Anterior vitreous Clear Clear
Dilated Fundus Examination (DFE) Normal See Fig. 40.1A

Questions to Ask

  • Do you have eye pain?

  • Did you receive intraocular antibiotics at the time of cataract surgery?

He reported no eye pain. Review of records showed he received intracameral vancomycin 1 mg/0.1 mL at the end of uncomplicated cataract surgery.

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