Ghostly Images

A 57 year old man developed blurred vision in first one eye, then the next, that looked like ghostly images seen through waxed paper. He had some pain behind the eyes, and a headache. He had used Viagra for erectile dysfunction that day, and had also previously used Cialis. The optic discs were mildly swollen, lit up on MRI, and despite intravenous steroids his vision went to no light perception within two days. Numbness, weakness, and unsteady gain quickly followed, and he was hospitalized. The patient was followed by neurology and neuro-ophthalmology, and finally neurosurgery for brain biopsy.