CASES | Peak Vision Care

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Case Reports

These five case reports are my original work that were submitted to the American Academy of Optometry for my fellowship candidacy. These cases have been reviewed by the Academy's admittance committee in 2017.

Case 1: Clinical Findings and Management of Epidemic Keratoconjunctivitis

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Abstract: Epidemic keratoconjunctivitis (EKC) is a severe, yet self-limiting conjunctival infection and inflammation associated with adenovirus types 8, 19, and 37. This case report follows the clinical course of a pediatric patient with EKC, outlines the importance of history and clinical observations in making the right diagnosis, and discusses treatment and management options for the disease.

Case 2: Clinical Findings and Management of Commotio Retinae with Berlin’s Edema

Abstract: Commotio retinae is a common manifestation of blunt trauma to the eye. This case report follows the clinical course of a patient presenting with commotio retinae after being struck with a kicked soccer ball. It highlights the clinical value of ocular coherence tomography in documenting and identifying various morphologic changes from blunt trauma over time.

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Case 3: A Case of Prolonged Visual Field Depression in Migraine with Aura

Abstract: Patients with a migraine headache may show visual field defects during and shortly after the migraine. These defects may be the result of transient ischemia and re-perfusion resulting in oxidative stress to the optic nerve much like the proposed pathogenesis for normal tension glaucoma, which has been linked to migraine sufferers. It is therefore prudent to inquire about migraine history during routine eye exams and to run visual fields and RNFL OCTs on migraine patients to monitor for and address any progressive nerve damage.

Case 4: Clinical Findings and Management of Acute Optic Neuritis as the Initial Manifestation of Multiple Sclerosis

Abstract: Multiple sclerosis (MS) is the most common cause of neurological disability among young adults. In some individuals, MS first manifests as an acute attack on the optic nerve. This case report follows the initial clinical diagnosis of optic neuritis suspicious of a clinically isolated syndrome (CIS), followed by final diagnosis of multiple sclerosis via neural imaging studies. This case highlights the importance of understanding the disease process, manifestations, prognosis, and treatment options of MS as an eye care provider.

Case 5: Clinical Findings and Management of Dark without Pressure

Abstract: Dark without pressure presents as an island or a patch of darker but otherwise normal retina in fundus examination with a condensing lens and a light source. On optical coherence tomography, these lesions show an abrupt attenuation of reflectivity in the ellipsoid zone and the outer segment layer. There have been few case reports since 1975 discussing these findings. To date, little is known about the structural and functional significance of this retinal presentation. Interestingly, these dark without pressure retina have been found in eyes with Oguchi’s disease. The relationship of dark without pressure to Oguchi’s disease remains unknown.

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