A 44-year-old obese woman with a medical history of iron-deficiency anemia (pretreatment hemoglobin of 8.8 g/dL) presented with blurred vision in her right eye and new headaches over 1 month. She described the headaches as holocephalic, rated them 4–5 out of 10 (where 1 is minimal intensity and 10 is maximal intensity) without any diurnal or positional variation. She had associated intermittent nausea, but no vomiting. She denied any characteristics consistent with a thunderclap headache. She initially saw her optometrist and was referred to neuro-ophthalmology for bilateral optic disc edema. Examination revealed a visual acuity of 20/30 OD and 20/20 OS, and Humphrey visual field testing showed an enlarged blind spot OD (MD −4.60 dB) and was normal OS (MD −2.10 dB). Slit-lamp examination revealed a posterior subcapsular cataract in the OD and dilated fundus examination showed moderate optic disc edema in both eyes with hemorrhages in all 3 retinal layers in the OD (shown in Fig. ). Her blood pressure was 128/78, and her hemoglobin was found to be 9.0 g/dL with mean corpuscular volume of 70.4 fL. Magnetic resonance imaging/magnetic resonance venography of the head was normal apart from signs of raised ICP, and lumbar puncture showed an opening pressure of 34 cm of water with normal CSF contents. She was started on acetazolamide 500 mg BID and continued her recent supplementation with ferrous fumarate. With significant weight loss, her optic disc edema resolved after 4 months, and she continued to maintain normal visual function. The final Humphrey mean deviation was −2.80 dB OD and −0.72 dB OS.
A 33-year-old man with no past medical history presented with a 3-day history of blurred vision and intense photophobia in the LE 3 weeks after the onset of mild chikenpox. On examination, BCVA was 20/20 in the RE and 20/30 in the LE. Slit-lamp examination of the LE showed perilimbal injection, fine keratic precipitates, and 2+ cells with 1+ flare in the anterior chamber. Intraocular pressure was 16 mmHg. There was no vitritis, and dilated fundus findings were normal. Examination results of the RE were normal. A diagnosis of unilateral acute non-granulomatous anterior uveitis secondary to varicella was made. The patient was treated by topical dexamethasone six times a day and cycloplegic agent twice daily. The uveitis resolved within 2 weeks, and visual acuity improved to 20/20 in the LE. No recurrence of uveitis was observed over a follow-up of 12 months.