Diagnostic Quiz
Systemic History Complicates Diagnosis
Andrew S. Gurwood,
O.D.
History
A 50-year-old black male complained of seeing white floating spots in his right eye for 2 months. The patient's medical history included sarcoidosis for 14 years; prostate cancer for 1 year, with recent metastasis to the ribs; and congestive heart failure. His medications included prednisone, Casodex (bicalutamide), Norvasc (amlodipine besylate), warfarin sodium and furosemide. He also was on home oxygen therapy. He denied any drug allergies.
Diagnostic Data
Best-corrected acuity was 20/20 O.U. at distance and near. External exam, pupil exam and anterior segment evaluation were all unremarkable. IOPs were 16mm Hg O.U. The findings from a dilated fundus exam of the right eye are shown.
Your Diagnosis
How would you approach this case? Does this patient require any additional tests? How would you manage this patient? What is his likely prognosis? To check your diagnosis, call the "Diagnostic Quiz" phone line at (610) 492-1050, or check Review of Optometry OnLine at www.revoptom.com.
The dilated fundus exam revealed these findings in the right eye of this 50-year-old black male.
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November 15, 2000