A 67-year-old black female reported to the office with a chief complaint of blurry vision at near, as well as facial skin lesions. She asked if there was any medication that could improve her skin cosmesis. Her systemic history was remarkable for hypetension, diabetes and dyslipidemia, which was well controlled medically with lisinopril, metformin and a statin, respectively.
Sudden-onset, unilateral, painless vision loss is certainly a cause for patient and doctor concern as it may indicate acute retinal ischemia (ARI). Transient monocular vision loss (TMVL) is the most common symptom of ARI with an incidence of approximately 14 per 100,000. Ophthalmic exams on TMVL patients usually lack significant findings and sequelae. In contrast, ARI from artery occlusions produce permanent visual acuity, visual field loss, or both. Though treatment is mostly futile in restoring vision in these cases, patients should still be emergently referred for a stroke work-up.
CMV gained recognition during the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) epidemic for causing infectious retinitis in susceptible patients. More recently, it has emerged as a cause of ocular and systemic sequelae in immunocompetent patients.3,4