The patient was a 66-year-old White woman who presented in early 2018 with decreased vision in the right eye for several weeks. Her past medical history included interstitial cystitis and Hashimoto’s thyroiditis. Her past ophthalmic history was remarkable for cataract surgery in both eyes. Her medications included Synthroid (levothyroxine – for thyroid insufficiency), Elmiron (pentosan – for interstitial nephritis), Coreg (carvedilol – a beta-blocker), Cymbalta (duloxetine – for anxiety), Amerge (naratriptan – for migraine headaches), Levsin-SL (hyoscyamine – for pain), and Nexium (esomeprazole – for GERD). Her initial visual acuity was 20/400 OD and 20/20 OS. She was treated with Avastin and the deep swelling in the right eye quickly resolved. The visual acuity in the right eye was 20/40 at the next visit and eventually improved to 20/25. Subsequently, the subjective vision has been stable. Could her entire clinical picture be explained by macular degeneration, or was there another condition contributing to her clinical picture?
