Visual Changes

Name: Patricia Thompson

Age: 40 Years Old

Date of Birth: 20th December 1984

Location: Emergency Department

Occupation: Interior Designer

“I have been losing vision since yesterday morning. I’ve never had something like that before, I’m worried there’s something wrong with my eyes!”

• Onset: Yesterday morning

• Progression: Sudden onset and comes in episodes. 

• Exacerbating Factors: Worse when bending over or coughing. Occasionally, bright lights are painful to look at. 

• Relieving Factors: Nothing makes it go away.

• Associated symptoms: Feels a little nauseous and dizzy, accompanied by a constant throbbing headache. Headache feels like a 5/10 all over the head, relieved (to a certain extent) with paracetamol, and made worse with bending over and coughing. 

• Timing: Comes and goes in short episodes 

• Episodes of being symptom-free: Vision is restored to normal function when not having an episode.

• Precipitating Factors : Started early in the morning as soon as I got out of bed. Not sure if anything triggered that.

• Recent illness: None.

• Recent head trauma: None.

• Recent travel: None.

• Previous episodes: Never experienced this before.

• Ideas: “I don’t have a clue what’s going on.”

• Expectations: “I don’t know what to expect. Do I need glasses?”

• Concerns: “Nothing particularly worries me as long as I don’t end up blind.”

• Bowel habits: Normal

• Urinary habits: Normal

• Appetite: Same as usual.

• Sleep: Feels sleepier ever-since symptom onset

• Weight: Has been gaining weight recently. Lack of time to take care of weight due to new projects at work. 

• Pain in the chest/abdomen: None

• Dizziness: None

• Loss of balance: None

• Fever: None

• ENT: Normal

• Cardiology: Normal

• Respiratory: Normal

Previous hospital admissions: None

Previous surgeries: None

Medical conditions:

• Hypertension (controlled with lifestyle modifications only)

Medications:

• Microgynon 30

Over the counters:

• Paracetamol

Allergies:

• Penicillin (Airway obstruction and severe rash)

Everyone in the family is healthy and well.

• Smoking: Doesn’t smoke. Used to smoke 5 cigarettes a day for about 10 years. Quit smoking 5 years ago.  

• Alcohol: A few gin-and-tonics every weekend with friends and colleagues.

• Recreational drugs: Never

• Diet: Usually takeaways on busy days. I try to cook at home whenever I can but have not been able to do that in the past few months.

• Exercise: Used to go for runs once every few days but had to stop two months ago due to a new project at work, leaving little time for anything else. 

• Ill contacts: No one around me were ill recently

• Home: Lives alone at home in an apartment flat. 

• Active Daily Living: Usually mobile and able to perform daily functions normally.