Sudden visual loss following abdominal surgery

Rodrigues, Gladys R and Sathyanarayan, Nooji and Mendonca, Teena Mariet and John, Tina Anne (2019) Sudden visual loss following abdominal surgery. BMJ Case Reports, 12. pp. 1-2. ISSN 1757-790X

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An 18-year-old man underwent hemicolectomy for carcinoma of the transverse colon. On the third postoperative day, the patient reported decreased vision in both eyes. The patient was a hypermetrope of +5.0DS. On examination, his best corrected visual acuity was 1/60 in both eyes. Amslers grid showed metamorphopsia in both eyes. Anterior segment and pupillary reactions were normal. Fundus examination revealed multiple patches of retinal whitening resembling soft exudates over posterior pole with predominant peripapillary distribution (figure 1). Foveal reflex was dull. Based on the classical fundus picture he was diagnosed to have Purtscher's like retinopathy. Optical Coherence Tomography (OCT) showed intraretinal oedema and mild subretinal fluid in macula of both eyes (figure 2 and figure 3). Intravenous steroids were advised but deferred after discussion with gastroenterologist due to risk of post hemicolectomy wound infection and poor systemic condition. Fundus fluorescein angiography (FFA) could not be done as patient was too debilitated. Patient was observed with periodic review. His vision gradually improved to 6/18 in both eyes.

Item Type: Article
Uncontrolled Keywords: purtschers retinopathy
Subjects: Medicine > KMC Mangalore > Ophthalmology
Depositing User: KMCMLR User
Date Deposited: 06 Jun 2019 09:41
Last Modified: 06 Jun 2019 09:41

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