An old lady with acute headache and sudden blindness

• Published in: Hong Kong journal of emergency medicine Vol. 28; no. 2; pp. 121 - 123
• Main Authors: Au, Sunny Chi Lik, Ko, Simon Tak Chuen
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.03.2021; Sage Publications Ltd
• Subjects: Arterial occlusions; arterial occlusive diseases; Autoimmune diseases; Blindness; Emergency medical care; Evaluation; Giant cell arteritis; Hyperbaric oxygenation; Hypertension; Older people; Retinal artery occlusion; Therapeutics; Vein & artery diseases; arterial occlusive diseases; giant cell arteritis; therapeutics; Retinal artery occlusion; hyperbaric oxygenation
• ISSN: 1024-9079; 2309-5407
• DOI: 10.1177/1024907920913665

A 60-year-old hypertensive lady experienced painless sudden visual loss in the right eye when resting at home. There was no traumatic injury, no eye pain, or flashes or floaters, or nausea, but mild right-sided headache for few days. She was not lifting heavy objects, nor straining. She managed to attend the emergency department within 1 h of onset of symptoms by herself walking into the consultation room unaided. Examination showed visual acuity with pinhole of hand movement over the right eye, right relative afferent pupillary defect and normal intraocular pressure of 15 mmHg. Extraocular movement was full without diplopia or pain. Eyes were not injected, and slit lamp examination was normal with clear cornea. Acute management of vascular causes of acute blindness and the role of hyperbaric oxygen therapy in ophthalmological disease in Hong Kong will be discussed.