Man referred for sudden onset decline in vision in left eye

A 62-year-old white man was referred to the retina clinic for evaluation of rapid decreased vision of his left eye occurring 5 days before presentation.The patient reported noticing a dark area of his vision in his left eye while he was watching television. He denied any eye pain. A review of systems was negative for fevers, chills, weight loss, night sweats, jaw claudication, scalp tenderness, diplopia and myalgias. He was seen by an outside ophthalmologist who started him on oral prednisone and timolol in the left eye for reasons that were “unclear” to the patient. He reported a vague history of a mechanical fall onto his back a few weeks prior but denied any head or eye trauma. Additionally, he reported noticing a gum abscess with purulent drainage the same day that his vision declined. The patient denied any steroid use or heavy lifting. He reported stopping taking his hypertension medications approximately 6 months prior, which he restarted once he began having these visual symptoms.