A 38-year-old Caucasian male complained of distorted vision in his right eye persisting for 24 hours. He also noticed that the lower half of his visual field in the eye was very blurry and partially obscured by a shadow. Visual acuity was counting fingers in the right eye and 20/20 in the left. IOP was 20 mmHg in the right eye and 19 mmHg in the left.
Dilated fundus exam showed scattered cotton-wool spots in both eyes with macular and diffuse disc edema in the right eye. The visual field was depressed in the eye, and optical coherence tomography showed macular edema. The patient was admitted to the emergency room where he presented with a blood pressure of 220/130. Lab work showed elevated cholesterol. The patient was diagnosed with hypertensive retinopathy with anterior ischemic optic neuropathy in the right eye.
Since the diagnosis, the patient has gained better control of his blood pressure (140/90) and has noticed visual improvement in the eye.
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