ABSTRACT
A 54-year-old male is seen in the local ophthalmology office. He has a past medical history significant for hyperlipidemia, hypertension, and erectile dysfunction. He woke yesterday with sudden awareness of decreased vision in his right eye, which has not improved. His visual acuity is 20/50 OD and 20/16 OS. He has a 1.2 log unit RAPD on the right. His visual fields reveal an inferior altitudinal defect on the right, and normal visual field on the left (Figure 13.1 and 13.2). His slit lamp exam is normal. His dilated fundus exam reveals disc edema on the right only, and a crowded optic nerve configuration on the left (Figure 13.3 and 13.4). OCT of the RNFL was also obtained (Figure 13.5) confirming the disc edema. As the
possibility of permanent vision loss is explained to the patient, and his vasculopathic risk factors are being addressed, the patient reminds the ophthalmologist about his taking medication for erectile dysfunction and asks if the drug caused this to happen.
