Topic outline

  • Grand Rounds

    A patient with slow and progressive, painless, visual decline OD for two weeks presents to BPEI ED. She also notes moderate intensity full-day headaches and TVOs in the same time period. She saw an outside provider and was referred to BPEI ED for optic nerve head elevation OD. Her exam was notable for 0/20 vision in both eyes. Intraocular pressures were within normal limits. Slit lamp exam was normal. Dilated fundus examination was notable for grade 3 optic nerve edema OD and grade 1 optic nerve edema OS. MRI brain and orbit findings were consistent with idiopathic intracranial hypertension. She was started on Acetazolamide 1000mg BID and counseled to aim for 6-10% weight loss. At her 6 week follow up exam, her headache has resolved. Her vision is still 20/20 and she has lost 10lbs. Her RNFL is thinner OU and her GCL and HVF continue to be normal.

    Presentation Date: 03/28/2024
    Issue Date: 04/19/2024