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Han-Ying P. Chang, Nancy Huynh, Sheila Borboli-Gerogiannis; Ophthalmic Diagnoses For Painless Change In Vision Amongst Inpatient Consults. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4212.
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To investigate and categorize specific symptoms and findings amongst inpatients admitted in a tertiary hospital for which an ophthalmology consult was requested for painless change in vision.
A retrospective review was conducted on all patients admitted at the Brigham and Women’s Hospital for which an ophthalmology consult was requested between October 2009 and October 2010. Attention was directed to consults for painless change in vision, with particular focus on patients’ presenting symptoms and final diagnoses.
Of the 346 inpatient consult requests seen by the Ophthalmology service during the one-year time period, 80 (23%) were for painless change in vision. Presenting eye symptoms in this group of patients were categorized as follows: 28 (35%) with persistent blurry vision, 10 (12.5%) with permanent vision loss, 10 (12.5%) with transient vision loss or blurry vision, 8 (10%) with diplopia, 10 (12.5%) with floaters, 7 (8.8%) with central scotomas, 1 (1.3%) with a monocular visual field defect, and 6 (7.5%) with positive visual phenomena. Ophthalmic diagnoses and findings included: 28 (35%) normal eye exam or longstanding, known eye pathology that was unchanged; 9 (11%) refractive error; 11 (14%) retinal or vitreous hemorrhage; 6 (7.5%) dry eyes; 5 (6.3%) optic neuropathy; 4 (5%) vitreous floaters/ detachment; 4 (5%) retinal vascular occlusion; 4 (5%) transient ischemic attack due to systemic vascular disease; 2 (2.5%) giant cell arteritis; 2 (2.5%) cranial nerve palsy; 5 (6.3%) other diagnoses.
Painless change in vision is a common complaint amongst inpatients admitted in a tertiary hospital. The ophthalmologist’s role is important in providing reassurance, assisting with diagnosis of a systemic disorder, initiating necessary ophthalmologic treatment, and arranging follow-up.
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