Central serous chorioretinopathy complicated by subsequent occipital lobe infarction and sinusitis in a drug abuser

The presence of multiple occurring, simultaneously complicated clinical findings can be challenging.

A 39-year-old white male presented initially with central serous chorioretinopathy. Later, the patient reported a great deal of pain over his left eye with nasal vision loss. Comprehensive ophthalmic evaluation and neurologic consultation were invaluable in the diagnosis and management of the patient.

Neurologic consultation along with computed tomography (CT) of the head with and without contrast enhancement along with magnetic resonance imaging (MRI) with and without gadolinium revealed lesions in the left occipital lobe, right cerebellum, and left thalamus area. In addition, bilateral maxillary and ethmoidal sinusitis were observed.

Multiple events affecting vision are often related, sometimes not. However, co-existing factors can confound and obscure accurate diagnoses. Careful patient clinical and laboratory investigations are frequently necessary to elucidate correct diagnosis.