Neuro-oph Case 3: Introduction

History of Present Illness (HPI)

A 32 year old female with a PMH of migraines and hypothyroidism presents due to vision loss in her left eye which began yesterday. She endorses pain around her eye that has been bothering her for the past few days as well. She feels the pain worsens upon eye movement. She is recovering from an upper respiratory tract infection that started about 10 days ago and endorses nasal congestion and cough. She denies recent headache, nausea, vomiting, changes in hearing, dysarthria, dysphagia, weakness.  She lives in Vermont, works as a school teacher, and has not traveled within the past year. She denies any similar episodes in the past. Her last migraine was two years ago.

acetaminophen as needed for migraines

What’s on your differential diagnosis? Choose at least 3 before moving on!
Retinal detachment
Central retinal artery occlusion (CRAO)
Central retinal vein occlusion (CRVO)
Ischemic optic neuropathy
Amaurosis fugax
Optic neuritis
Migraine with aura
Thyroid orbitopathy

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