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Download the article PDF: Clinical Challenges June 2025
A 63-year-old man presents to urgent care with sudden-onset floaters and blurred vision in his right eye for one day. He denies trauma, headache, or flashes of light. He has no history of similar symptoms. His past medical history includes hypertension and type 2 diabetes.
Vital signs are normal. Visual acuity measures 20/40 OD and 20/25 OS. No facial asymmetry or eyelid swelling is noted. Visual fields are intact bilaterally. A non-dilated fundoscopic exam is attempted but is limited. Blood glucose is within normal limits. With concern for retinal pathology, a point-of-care ultrasound (POCUS) of both eyes is performed using a linear probe over closed eyelids.
View the POCUS images below and consider the likely diagnosis and next steps. The resolution of the case is described on the following page.
Case provided by Tatiana Havryliuk, MD, emergency physician in New York, NY, and founder of Hello Sono.