April 23, 2017
A 57-year-old man presented to the Lahey Medical Center ophthalmology clinic with a 1-month history of transient blurred vision in both eyes. His medical history was significant for hypertension, diabetes type 2, osteoarthritis, chronic back pain and a cholesteatoma, which was surgically treated with right tympanomastoidectomy 6 weeks before presentation. His ocular history was significant only for mild myopia, for which he was already wearing glasses.
On evaluation in the eye clinic, he endorsed a month-long history of intermittent blurred vision. He noted recurrent episodes of vision loss in both eyes that lasted only a few seconds. The patient noticed the vision would get very blurry and dim. Between these episodes, the vision returned to normal. He was unsure if the vision loss was positional. He was experiencing more frequent episodes, which prompted him to schedule an eye exam. He denied any headaches, nausea or vomiting. He did not endorse any pulsatile tinnitus or increased intracranial noises. He felt systemically well and had no recent sick contacts. He denied any scalp tenderness, jaw claudication, fevers, weight loss, fatigue or myalgias. He had no recent travel.