FP852 : A rare case of silent stroke in young – An Ophthalmologist’s role

Dr.Manjunath Natarajan

A 45yr old male patient with no previous systemic/ ocular history, came with sudden onset of severe unilateral headache, complaints of not being able to see objects that are upwards and left.

Systemic examination (including CNS) was normal

Best corrected visual acuity in both eyes was 6/6 and N6 and ocular examination was normal, we were able to rule out migraine by clinical suspicion.

Perimetry – bilateral left sided superior quadrantanopia

MRI brain – Acute ischaemic changes across right temporo-parietal cortical regions.

Carotid & vertebral artery doppler – diffuse mild intima and media thickening in both carotid arteries.

Lipid profile – high VLDL & LDL.

Patient was referred to a Neurologist & after treatment, patient showed good improvement.

This case scenario was an early presentation of a rare disease. If left undetected the patient could have progressed to full-blown stroke with neurological deficits. Early & prompt diagnosis with clinical suspicion saved the day.