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Hemeralopia in an older adult
1Duke University Eye Center, Durham, North Carolina.
Survey of Ophthalmology
|November 1, 1992
Summary
A rare visual paraneoplastic syndrome caused acquired photoreceptor dysfunction in an elderly male. This condition, characterized by difficulty seeing in bright light, was linked to lung cancer.
Area of Science:
- Ophthalmology
- Oncology
- Neuro-ophthalmology
Background:
- Acquired photoreceptor dysfunction can manifest as hemeralopia (difficulty seeing in bright light), even after cataract surgery.
- Visual symptoms may indicate underlying systemic disease, necessitating comprehensive evaluation.
Observation:
- An elderly male presented with persistent hemeralopia unresponsive to cataract extraction.
- Ophthalmoscopy revealed arteriolar attenuation, optic disc pallor, and retinal pigment epithelial changes.
- Visual field testing showed paracentral scotomata, and electroretinography indicated widespread photoreceptor degeneration.
Findings:
- The patient was diagnosed with a visual paraneoplastic syndrome.
- Systemic workup identified an underlying squamous cell carcinoma of the lung.
Implications:
- This case highlights the importance of investigating persistent visual disturbances, such as hemeralopia, for potential paraneoplastic syndromes.
- Early diagnosis and management of the underlying malignancy are crucial for patients with visual paraneoplastic syndromes.
- Understanding acquired photoreceptor dysfunction in adults is essential for accurate diagnosis and treatment planning.