DR. UNNATI SHUKLA

Dr.Tejas Himanshu Desai

Abstract

A young 26-year-old patient presented with the complaints of blurring of vision in the right eye with scotoma in the superior visual field for 3 days. On examination, the visual acuity of the right eye was counting fingers at 5 ft. Left eye visual acuity was 6/6. Both eye intraocular pressure was normal. On clinical examination the anterior segment of both eyes was normal. Right eye fundus examination revealed the presence of vascular tortuosity, multiple flame shaped hemorrhages ,dot and blot hemorrhages and cotton wool exudates.The was a pale area of non perfusion along the inferotemporal retinal artery.The left eye fundus findings were unremarkable.FFA showed delayed arterial filling with prolonged AV transit time. Patient was diagnosed as combined central vein and inferotemporal branch retinal artery occlusion.Patient underwent immediate paracentesis and ocular massage. On systemic investigation, patient was diagnosed with mitral valve disease with elevated homocysteine levels.