Central serous retinopathy: an unusual cause of acute visual loss

ABSTRACT Ophthalmologic complaints represent approximately 2% of emergency department (ED) visits. Acute vision loss is the most serious of such presentations and requires prompt assessment for a treatable cause. The differential diagnosis for acute vision loss includes retinal detachment, macular disorders, vaso-occlusive disorders, temporal arteritis, neuro-ophthalmologic disorders, and functional disorders. We report the case of a previously healthy 33-year-old man who presented to the ED with acute bilateral vision loss that was ultimately diagnosed as central serous retinopathy (CSR), an idiopathic, self-limited condition that typically affects males age 20 to 50 years. This condition is not mentioned in standard emergency medicine textbooks or the emergency medicine literature, and our hope is that our report will serve to illustrate a typical case of CSR and help prompt emergency physicians to consider this diagnosis in the appropriate circumstances.

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Acute Visual Loss Induced by Dexamethasone during Neoadjuvant Docetaxol

Clinical medicine Oncology ◽

10.4137/cmo.s339 ◽

2008 ◽

Vol 2 ◽

pp. CMO.S339

Author(s):

D.L. Gregory ◽

C.D. Jones ◽

E.R.E. Denton ◽

A.N. Harnett

Keyword(s):

Breast Cancer ◽

Visual Acuity ◽

Neoadjuvant Chemotherapy ◽

Visual Loss ◽

Chemotherapy Regimen ◽

Acute Onset ◽

Second Line ◽

Central Serous Retinopathy ◽

Steroid Dose ◽

Acute Visual Loss

We present a case of a female patient who developed acute onset of visual loss due to central serous retinopathy as a consequence of steroid premedication for docetaxol given as second line neoadjuvant chemotherapy for breast cancer. Central serous retinopathy is a recognised association with steroids but has not been previously reported in association with the management of solid tumours. Reduction in steroid dose and duration permitted recovery of her visual acuity while allowing completion of the prescribed chemotherapy regimen. An overview of the presentation, pathogenesis, aetiologies and management of central serous retinopathy is given.

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Unilateral Vision Loss without Ophthalmoplegia as a Rare Complication of Spinal Surgery

Journal of Neurosciences in Rural Practice ◽

10.4103/jnrp.jnrp_470_16 ◽

2017 ◽

Vol 08 (02) ◽

pp. 288-290 ◽

Cited By ~ 1

Author(s):

Elif Akpınar ◽

Mehmet Sabri Gürbüz ◽

Gülfidan Bitirgen ◽

Mehmet Özerk Okutan

Keyword(s):

Spinal Surgery ◽

Visual Loss ◽

Vision Loss ◽

Rare Complication ◽

Central Retinal Artery Occlusion ◽

Retinal Artery Occlusion ◽

Artery Occlusion ◽

Ischemic Optic Neuropathy ◽

Acute Visual Loss ◽

Retinal Artery

ABSTRACTPostoperative visual loss is an extremely rare complication of nonocular surgery. The most common causes are ischemic optic neuropathy, central retinal artery occlusion, and cerebral ischemia. Acute visual loss after spinal surgery is even rarer. The most important risk factors are long-lasting operations, massive bleedings, fluid overload, hypotension, hypothermia, coagulation disorders, direct trauma, embolism, long-term external ocular pressure, and anemia. Here, we present a case of a 54-year-old male who developed acute visual loss in his left eye after a lumbar instrumentation surgery and was diagnosed with retinal artery occlusion.

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Navigation-guided nasal endoscopic surgery for acute vision loss caused by fibrous dysplasia: a case report and review of literatures

BMC Surgery ◽

10.1186/s12893-021-01459-x ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Weijie Liu ◽

Wenhao Jiang ◽

Mingna Xu ◽

Xiaozhou Hu ◽

Mengting Wang ◽

...

Keyword(s):

Fibrous Dysplasia ◽

Endoscopic Surgery ◽

Visual Loss ◽

Vision Loss ◽

Neurological Complication ◽

Bone Cyst ◽

Cyst Formation ◽

Case Presentation ◽

Acute Visual Loss ◽

Gradual Process

Abstract Background Bone fibrous dysplasia is a benign disease of bone tissue dysplasia. Vision impairment is the commonest neurological complication of craniofacial fibrous dysplasia. Most of the vision loss caused by craniofacial fibrous dysplasia is usually a gradual process. Very few present with acute visual impairment as described in our case. Case presentation We report a patient with fibrous dysplasia presenting rapidly progressive visual loss in the left eye secondary to bone cyst formation. Transnasal endoscopic surgery guided by navigation with drainage and curettage of this bone cyst and orbital decompression resulted in progressive improvement in visual acuity that returned to normal 1 month post-operatively. Conclusions In cases with acute visual loss due to fibrous dysplasia, emergency surgical treatment should be considered to preserve vision. In the surgical approach, navigation-guided nasal endoscopic surgery may be preferred because of its advantages.

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Emergency Physicians Performing Point-of-Care Lung Sonography to Diagnose Pneumonia: A Prospective Multicenter Study

Journal of Diagnostic Medical Sonography ◽

10.1177/8756479320983248 ◽

2021 ◽

pp. 875647932098324

Author(s):

Mohammad Amin Zare ◽

Mahtab Mizani ◽

Azadeh Sameti ◽

Alireza Bahmani ◽

Marzieh Fathi

Keyword(s):

Multicenter Study ◽

Predictive Value ◽

Point Of Care ◽

Signs And Symptoms ◽

Clinical Syndrome ◽

Emergency Physicians ◽

Prospective Multicenter Study ◽

Lung Sonography ◽

Ed Visits ◽

Limited Accuracy

Objective: There has always been some issues in the accurate diagnosis of pneumonia, a common cause of emergency department (ED) visits and revisits, which is typically made based on the patient’s clinical syndrome. This is made more difficult due to the traditional chest radiography having limited accuracy. This prospective multicenter study was conducted to determine the diagnostic accuracy of a point-of-care lung sonography performed by emergency physicians for the diagnosis of pneumonia in an acute care setting. This was compared with chest computed tomography (CT), the diagnostic gold standard. Methods: ED patients who presented with signs and symptoms of pneumonia were eligible to enroll in the study. After enrollment, point-of-care lung sonography was performed on patients by emergency physicians who had passed a focused teaching course on lung sonographic findings of pneumonia. All enrolled patients were followed up. Patients who underwent a chest CT during their hospital admission course were finally included and analyzed. Results: Emergency physicians who performed a point-of-care lung sonography had a sensitivity of 100%, specificity of 75%, positive predictive value of 88.88%, negative predictive value of 100%, and an overall accuracy of 90% in the diagnosis of pneumonia. Conclusion: These emergency physicians could accurately diagnose pneumonia, with a point-of-care lung sonography, after completing a focused sonography course.

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The International Federation for Emergency Medicine report on emergency department crowding and access block: a brief summary

International Journal of Emergency Medicine ◽

10.1186/s12245-020-00312-x ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

A. P. Javidan ◽

◽

K. Hansen ◽

I. Higginson ◽

P. Jones ◽

...

Keyword(s):

Emergency Department ◽

Emergency Medicine ◽

Task Force ◽

Video Conferencing ◽

International Federation ◽

Emergency Physicians ◽

Emergency Department Crowding ◽

Comprehensive Guidance ◽

The World ◽

Ed Crowding

Abstract Objective To develop comprehensive guidance that captures international impacts, causes, and solutions related to emergency department crowding and access block Methods Emergency physicians representing 15 countries from all IFEM regions composed the Task Force. Monthly meetings were held via video-conferencing software to achieve consensus for report content. The report was submitted and approved by the IFEM Board on June 1, 2020. Results A total of 14 topic dossiers, each relating to an aspect of ED crowding, were researched and completed collaboratively by members of the Task Force. Conclusions The IFEM report is a comprehensive document intended to be used in whole or by section to inform and address aspects of ED crowding and access block. Overall, ED crowding is a multifactorial issue requiring systems-wide solutions applied at local, regional, and national levels. Access block is the predominant contributor of ED crowding in most parts of the world.

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P026: Need for training in medical education: staff emergency physician perspectives

CJEM ◽

10.1017/cem.2017.228 ◽

2017 ◽

Vol 19 (S1) ◽

pp. S86

Author(s):

J. Bryan ◽

F. Al Rawi ◽

T. Bhandari ◽

J. Chu ◽

S. Hansen ◽

...

Keyword(s):

Emergency Medicine ◽

Medical Education ◽

Adult Education ◽

Family Medicine ◽

Graduate Training ◽

Formal Training ◽

Emergency Physicians ◽

Allied Health Professionals ◽

Evaluation Time ◽

Post Graduate Training

Introduction: Emergency medicine physicians in our urban/suburban area have a range of training in medical education; some have no formal training in medical education, whereas others have completed Master’s level training in adult education. Not all staff have a university appointment; of those who are affiliated with our university, 87 have appointments through the Department of Medicine, 21 through the Department of Pediatrics, and 117 through the Department of Family Medicine. Emergency physicians in our area are a diverse group of physicians in terms of both formal training in adult education and in the variety of settings in which we work. The purpose of this study was to gauge interest in formal training in adult education among emergency medicine physicians. Methods: With research ethics board approval, we created and sent a 10-item electronic questionnaire to emergency medicine staff in our area. The questionnaire included items on demographics, experience in emergency medicine, additional post-graduate training, current teaching activities and interest in short (30-60 minute) adult education sessions. Results: Of a potential 360 active emergency physicians in our area, 120 responded to the questionnaire (33.3%), representing 12 area hospitals. Nearly half of respondents had been in practice over 10 years (48.44%). Respondents were mainly FRCP (50%) or CCFP-EM (47.50%) trained. 33.3% of respondents had masters degrees, of which 15% were MEd. Most physicians were involved in teaching medical students (98.33%), FRCP residents (80%) and family medicine residents (88.3%), though many were also teaching off-service residents, and allied health professionals. More than half of respondents (60%) were interested in attending short sessions to improve their skills as adult educators. The topics of most interest were feedback and evaluation, time-efficient teaching, the learner in difficulty, case-based teaching and bedside teaching. Conclusion: Emergency physicians in our area have a wide variety of experience and training in medical education. They are involved in teaching learners from a range of training levels and backgrounds. Physicians who responded to our survey expressed an interest in additional formal teaching on adult education topics geared toward emergency medicine.

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