| Identifier |
walsh_2015_s2_c5-2 |
| Title |
It's Not Just a FAD, (EHR Fatigue Syndrome) |
| Creator |
Jacqueline A. Leavitt |
| Subject |
Vision loss; Field loss; Fatigue; Intracranial Tumor |
| History |
A 29 year-old female nurse, nine months postpartum, presented with an inability to see her computerwell for the past two months. She denied eye pain, diplopia, numbness, tingling or weakness. Therewere no changes in vision in bright vs. dim lighting. She also had a headache at the back of her head fortwo months that was relieved with OTC medications. She denied any events immediately preceding theblurred vision. She also complained of shortness of breath, unexplained weight loss and extreme fatigue,sleeping 10 hours per night and taking naps over her lunch break at work. Workup by her primary caredoctor revealed a normal CXR, ECG with sinus bradycardia and anemia (Hgb 9.6, Hct 28.7). Towardsthe end of her recent pregnancy she was evaluated for polydipsia (drinking up to 9 L /d) and nocturia (6-7 x /night). Water deprivation testing during pregnancy was not possible but sodium of 133 made thediagnosis of diabetes insipidus (DI) unlikely. Symptoms improved after delivery and therefore thepolyuria and polydipsia was attributed to pregnancy. Postpartum she also developed fairly severeanxiety and depression that was managed with sertraline and clonazepam. On examination, bestcorrected visual acuity was 20/30 OU, Ishihara color plates were 11/13 OD, 13/13 OS. Pupils reactedbriskly without an RAPD. Visual fields were full to confrontation. Slit lamp and dilated fundusexamination was unremarkable, including absence of macular abnormalities or optic discpallor. Goldmann fields showed a suggestion of a homonymous field defect, but had variable responsesand the perimetrist noted that she was often falling asleep during the test. Optical coherencetomography showed a normal average retinal nerve fiber layer thickness OU. Lab workup showed anelevated ESR of 70 and an elevated ACE of 62.Tests were performed. |
| Date |
2015-02-22 |
| Language |
eng |
| Format |
application/pdf |
| Type |
Text |
| Source |
2015 North American Neuro-Ophthalmology Society Annual Meeting |
| Relation is Part of |
NANOS Annual Meeting Frank B. Walsh Sessions; 2015 |
| Collection |
Neuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu |
| Publisher |
Spencer S. Eccles Health Sciences Library, University of Utah |
| Holding Institution |
North American Neuro-Ophthalmology Association. NANOS Executive Office 5841 Cedar Lake Road, Suite 204, Minneapolis, MN 55416 |
| Rights Management |
Copyright 2013. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright |
| ARK |
ark:/87278/s6n0445t |
| Contributor Primary |
Lynn K. Gordon |
| Contributor Secondary |
Guy V. Jirawuthiworavong |
| Setname |
ehsl_novel_fbw |
| ID |
179301 |
| Reference URL |
https://collections.lib.utah.edu/ark:/87278/s6n0445t |
