Monitoring Diabetic Vision Changes in a Patient With Amblyopia

Introduction. Amblyopia is a condition where vision loss exists in the absence of structural anomalies or ocular disease. Deterioration of vision can be missed in patients who have diseases that might lead to vision loss if they also have amblyopia. It is important to recognize the additional attention required when patients have diseases concurrent with amblyopia. Case Presentation. A 66-year-old Hispanic male presented with complaint of flashes and a floater OD, which is generally associated with retinal detachments or posterior vitreous detachments. Ocular history was remarkable for strabismic amblyopia OS. Medical history was positive for Type II diabetes, hypertension and hypercholesterolemia. Dilated fundus exam showed a PVD (OD) explaining the flashes and floater. However, it was also noted that his best-corrected acuity was reduced in the left eye from the previous visit from 20/40 to 20/60. Macular edema secondary to diabetes was suspected and confirmed with further testing. Deviation From the Expected. A complication from diabetes was detected because it was recognized that there was vision loss not consistent with amblyopia. Typically, patients who have vision loss from diabetic complications are aware of any reduction in their vision. This patient was unaware of his visual loss due to his preexisting amblyopic condition. Conclusion. Patients who already have poor vision in one eye due to nondiabetic vision loss may not notice further vision deterioration due to diabetic complications. Suggestions on how to monitor for future vision changes in these types of patients are discussed.