A 40-year-old otherwise healthy woman noticed pain, redness, watering, photophobia, and decreased vision in both eyes one week after the onset of severe chickenpox. On examination, BCVA was counting fingers in the RE and 20/200 in the LE. Slit-lamp examination showed perilimbal injection and a geographic corneal epithelial defect associated with diffuse stromal edema in both eyes (Fig. ). The anterior chamber was deep and quiet, and there were no vitritis or abnormal fundus findings.\nA diagnosis of varicella keratitis was made. The patient was treated with systemic acyclovir (30 mg/kg/day). Oral steroids (0.5 mg/kg/day) were added 6 days after antiviral treatment, because of the severe associated stromal edema. The corneal defect resolved slowly within 2 weeks, and the medication was discontinued.\nThree months later, the patient presented with complaints of decreased vision and eye pain bilaterally. On examination, BCVA was 20/35 in both eyes. Slit-lamp examination showed perilimbal injection, many small raised dendriform lesions, and marginal infiltrates in the cornea of both eyes. A diagnosis of recurrent varicella keratitis was made, and the patient was once again treated with systemic acyclovir (30 mg/kg/day) and oral steroids (0.5 mg/kg/day) 4 days later. Corneal lesions resolved within 2 weeks with residual peripheral corneal scars (Fig. ), and visual acuity improved to 20/25 in both eyes. No recurrence of keratitis was observed after 18 months of follow-up.
A 42-year-old obese woman presented to her optometrist after she noticed “after images” following bright light exposure in her left eye (OS). She also noticed transient blurred vision with position changes but denied any regular headaches or pulsatile tinnitus. She denied ever having a severe onset headache. She was referred to neuro-ophthalmology and was found to have a visual acuity of 20/20 in both eyes. Humphrey 24-2 SITA-Fast visual fields showed nonspecific depressed points right eye (OD; MD −6.18 dB) and showed an enlarged blind spot OS (MD −4.84 dB). Dilated fundus examination showed moderate optic disc edema in both eyes with preretinal, intraretinal, and subretinal hemorrhages around the left optic disc (shown in Fig. ). Her blood pressure measured 140/100 and her hemoglobin was normal. Magnetic resonance imaging/magnetic resonance venography was performed and showed signs of raised ICP without a secondary cause. Lumbar puncture showed an opening pressure of 32 cm of water and normal cerebrospinal fluid (CSF) contents. She was started on acetazolamide 500 mg twice-daily (BID) and telmisartan 40 mg daily and the optic disc edema improved and resolved after 4 months with significant weight loss. She maintained normal visual function and the ODH resolved at 3 months. The final Humphrey mean deviation was −3.42 dB OD and −2.98 dB OS.