Diagnostic and Therapeutic Challenges

摘要

A 50-year-old woman presented with a 4-day history of painless inferior visual field loss in the left eye. Before the onset of symptoms, she reported a fit of sneezing after which she developed immediate tunnel vision in the left eye and a mild generalized headache. Both symptoms completely resolved after a short nap. She resumed her normal daily activities and went to sleep that night without any worrisome symptoms. When she awoke the next morning, she noted inferior visual field loss in the left eye. This scotoma was stable over the next 4 days before our evaluation. Her medical history was remarkable for gastro-esophageal reflux disease and left-sided Bell palsy, which occurred >2 years before and had completely resolved. She denied previous eye trauma or surgery. Her medications were Lanso-prazole and hormone replacement therapy.