When All Else Fails, Lay on Hands

A 57-year-old woman complained of eight months of photopsias and dark spots in her left eye, beginning one month after her second renal transplant. Over the next seven months, her visual acuity remained 20/25 OS, the left optic nerve edema worsened, and she developed progressive field loss OS. A number of futile therapeutic attempts occurred, further diagnostic testing occurred, and a biopsy and therapeutic procedure were performed. Although the left eye field and disc appearance initially improved with these attempts, the vision in the left eye worsened in a stepwise fashion to no light perception over months. Vision OD worsened to 20/40, and the visual field developed generalized contraction, and altitudinal loss. The right eye developed minimal disc fullness, and intraocular pressures increased dramatically on the right.