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Sudden vision loss in a 68-year-old man: the life-saving value of funduscopy
  1. Laura Donaldson1,
  2. Safwan Tayeb2,
  3. Edward Margolin2,3
  1. 1 Department of Surgery, Division of Ophthalmology, McMaster University, Hamilton, Ontario, Canada
  2. 2 Department of Ophthalmology and Vision Science, University of Toronto, Toronto, Ontario, Canada
  3. 3 Department of Medicine, Neurology, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Dr Edward Margolin, 801 Eglinton Ave West Suite 301, M5N 1E3, Toronto, Canada; edmargolin{at}

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Clinical introduction

A 68-year-old man awoke with severe vision loss in the right eye. Three days later, he sought medical attention in the ED. Vision was no light perception in the right eye and 6/6 in the left eye with right brisk relative afferent pupillary defect. Fundus examination is shown in figure 1. Inflammatory markers were ordered and were normal.

Figure 1

Fundus examination in a patient with sudden painless vision loss in the right eye.


What is the diagnosis?

  1. Haemorrhage related to age-related macular degeneration

  2. Central retinal artery occlusion

  3. Retinal detachment

  4. Proliferative diabetic retinopathy


(B) Central retinal artery occlusion (CRAO). While the centre of the macula, the fovea, has a bright red appearance, this is not a haemorrhage (answers A and D). Ischaemic retina …

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  • Contributors All authors contributed equally to data gathering, manuscript writing, preparation and final approval.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.