Physical Address

304 North Cardinal St.
Dorchester Center, MA 02124

Multiple Evanescent White Dot Syndrome (MEWDS)


History of Present Illness

A 25-year-old woman developed a “flulike” illness 4 weeks ago. In the past 48 hours she suddenly developed painless loss of vision in the left eye (OS) without redness or photophobia. She noticed a small blind spot and shimmering lights (photopsias) in her temporal visual field. The night before her loss of vision, she attended a party and snorted cocaine for the first time.

Exam
OD OS
Visual acuity 20/20 20/80
Intraocular pressure (IOP) (mm Hg) 11 10
Sclera/conjunctiva Clear. No injection Clear. No injection
Cornea Clear Clear
Anterior chamber (AC) No cell or flare No cell or flare
Iris Normal Normal
Lens Clear Clear
Vitreous cavity Clear Trace vitreous cells
Retina/optic nerve Normal Small white dots, deep in retina ( Fig. 33.1A ), with hyperemia, trace optic disc edema, and foveal granularity ( Fig. 33.1B )

Fig. 33.1, (A) Temporal paramacular retina with white dots, OS. (B) Foveal granularity, hyperemia, and trace optic disc edema, OS.

Questions to Ask

  • Have you had sudden visual loss in either eye before now?

  • Have you fully recovered from the flu—namely, do you still have malaise, lethargy, or tiredness?

  • Have you been diagnosed with a blood or bone marrow disorder in the past?

  • Are you being treated for any systemic disease affecting other organs?

Her answer to each question is “no,” except although she has recovered from the flu, she still has mild malaise.

You're Reading a Preview

Become a Clinical Tree membership for Full access and enjoy Unlimited articles

Become membership

If you are a member. Log in here

Related Posts