Abstract
A pediatric patient accompanied by their parent presented to BPEI ED complaining of an episode of complete loss of vision in the left eye that was initially blurry, then totally black, lasting from 20-30 seconds. The symptom was associated with a frontal headache. The patient has a reported use of steroid for asthma and antibiotics for multiple past infections. The patient was started on Diamox 2 years prior but had been off for a while. Patient had a past medical history relevant for a viral meningitis at age 2 y/o and asthma. On eye exam, visual acuity without correction was 20/40 in both eyes, pupils were equal, round and reactive with no APD, intra ocular pressure was within normal limits and color plates were full. On slit lamp examination anterior segment was unremarkable and fundus exam showed grade 2 optic nerve edema on the right eye and grade 3 optic nerve edema on the left eye. Ultrasound of both eyes showed no optic disc drusen. Patient had previous lumbar puncture at an outside institution with opening pressure of 30 cm H2O and normal CSF. MRI brain and orbits with and without contrast and MRV head without contrast were ordered which showed prominence of the optic nerve sheaths bilaterally and no signs of thrombosis. A diagnosis of Idiopathic Intracranial Hypertension was made, and the patient was started on Diamox 250 mg twice a day with improvement of headache and nearly resolution of their papilledema. The patient remains stable and continues to be followed closely.
Presentation Date: 03/27/2025
Issue Date: 04/18/2025