A 25-year-old Black man presented to the Tufts Medical Center emergency department with blurred vision in both eyes.
The vision changes started in the left eye and progressed to involve the right eye 4 days later. He denied pain, photophobia, flashes or floaters in either eye. The patient had presented to an outside ED with fever and headache just before onset of the vision changes, and he was subsequently discharged with migraine headache. He also endorsed a significant amount of stress as a banker with additional recent stressors related to his family life. Medical history was unremarkable,