I'm having trouble diagnosing this case. It's for a physiology class. I'm not sure if I'm allowed to post here but I've been researching for a bit now and I've come to somewhat of a diagnosis but I'm not completely sure.
So far all I've gotten is she has relative afferent pupillary defect. I've ruled out retinal detachment, multiple sclerosis, and possibly lesions since her NCV is normal. Right now I'm thinking early stages of glaucoma or a brain tumor but that's a bit of stretch.
Any input would be appreciated thanks!
Here's the info we're given.
Female, 23 years old, has not experienced any falls or other head trauma from what she can remember. Her pupils are the same size in room light, when a light is shined into her right eye there's a restricted direct and consensual pupillary reflex, but when done in the left eye it shows a normal direct and consensual pupillary reflex. Her blink reflex and color vision are both normal. There's no bacterial infection and no drug use according to her blood test.
visual acuity is 20/50 || normal: 20/40 - 20/80
resting blood pressure: 108.67mmHg || normal: 110/70 mmHg
blood alcohol level 0% by vol.
hemoglobin: 10.8 g/dl || normal 11-14 g/dL
nerve conduction velocity: 52 m/s || normal: 50-60 m/s
grip strength max: 20kg || normal 17-35 kg
grip strength half-peak fatigue: 37 s || 35-45 s
There is not enough information given to rule much out. There are many potential causes of the described pupil reaction defect. The vision in each eye needs to be known and a detailed eye exam performed. You definitely want to worry about things like tumors and aneurysms. Normal vision is 20/20. So either the patient needs glasses or something else is going on.
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