Ophtho On Call Case 2: Introduction

History of Present Illness (HPI)

A 74 year old male with a past medical history significant for hypertension, type 2 diabetes mellitus, hyperlipidemia, and recent left middle cerebral artery stroke with no residual deficits presents to the emergency department due to sudden,  painless vision loss in his left eye. He states that he was at home watching TV about two hours ago when all of a sudden he had trouble seeing the screen. When he covered his right eye, he noticed he could barely see out of his left eye. He denies any flashes or floaters. He still cannot see out of his left eye, prompting his wife to bring him to the ED. He reports that he has been compliant with his medications and follows up with his PCP yearly. His last wellness visit was almost a year ago and he had perfect vision at that time.

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
Vitreous hemorrhage
Acute angle closure glaucoma
Macular degeneration
Diabetic retinopathy

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