Man referred for acute onset of distortions, decreased vision

A 53-year-old man was referred for cataract evaluation at Lahey Medical Center. Over the previous month, he noticed a gradual decrease in vision to the point where he had difficulty driving and functioning in his career as a mailman. His primary complaint was “difficulty focusing” at far and near despite a recent prescription for new glasses.The patient denied any alleviating or aggravating factors. His medical history was significant for poorly controlled insulin-dependent diabetes and multiple prior deep venous thromboses. He was a glaucoma suspect based on optic nerve asymmetry. His family history was noncontributory.