PUBLICATION EXCLUSIVE: Woman presents with cloudy declining vision and flashes

A 56-year-old Caucasian woman presented with painless, slowly decreasing “murky” vision in the left eye over a period of 3 weeks, along with flashes. Her ocular history was positive for hemorrhagic posterior vitreous detachment after blunt trauma with a basketball to the same eye 4 months earlier. On that exam, she was also noted to have “fullness of the optic nerve, venous beading and inferior drusen OS.” Despite the physician’s recommendation to return after 4 to 6 weeks, the patient was lost to follow-up until new visual symptoms started. She had also undergone strabismus surgery 30 years earlier and had incipient cataracts, myopia and presbyopia.Medical history included migraines and osteoarthritis. She was taking eletriptan, magnesium oxide and melatonin. Family history was only positive for coronary artery disease and diabetes in the father. She was working as a sales engineer and denied any history of intravenous drug use or high-risk sexual activity. Review of systems was positive for remote history of genital herpes.