Diagnostic and Therapeutic Challenges

摘要

A 19-year-old man noted some vague blurring of vision in both eyes, which progressively worsened. At the age of 43 years during a routine examination, an eye doctor told him that his visual acuity would not qualify to drive a car. He noted slowly progressive central visual loss for 2 years before presentation at the age of 46 years. He denied photophobia, hemeralopia, nyctalopia, orphotop-sias. He took no medications. He had smoked one pack of cigarettes per day for the past 27 years. He consumed one to two alcoholic beverages per week. The patient denied use of illicit drugs, herbal supplements, or retinotoxic substances. He denied sungazing. He worked as a truck driver hauling liquid manure but did not chronically contact chemicals. His parents were both alive and still driving. Four siblings and three children had no history of visual difficulties.