Patient History: The patient is an 85-year-old female who noted sudden-onset darkening of her central vision surrounded by a gray ring-like pattern in her right eye. She had no associated photopsias, metamorphopsia, or new floaters. She denied any eye pain, diplopia, redness, or a headache. She had no history of ocular trauma, transient ischemic attacks, or neurologic symptoms. Past Ocular History: Ocular hypertension Pseudoexfoliation Cataract surgery OD Nuclear sclerotic cataract OS Medical History: Hypertension, hypothyroidism, osteopenia, hypercholesteremia.
Medications: Timolol drops OU. Systemic medications include aspirin, levothyroxine, losartan, simvastatin, risedronate, tolterodine tartrate. Physical Exam: Visual acuity (with correction): 20/70+1 OD and 20/60 OS Extraocular motility: Full OU. Orthophoric in the primary position. Pupils: 4 → 2 mm OD, OS, no relative afferent…
