A 64-Year-Old Woman With Blurred Vision and Loss of Balance

Heidi Moawad, MD

Disclosures

November 19, 2018

Editor's Note:
The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to recognize accurately. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case that you would like to suggest for a Challenge, please contact us.

Background

A 64-year-old woman presents to her primary care physician's office with blurry vision. Upon further questioning, she also says that she has been using the handrails when she walks up or down the stairs and has occasionally felt off-balance while walking during the past year; however, she has not fallen. Her husband, who has accompanied her, says she has been quiet and unmotivated for the past 2 years since she retired from her job as an administrative assistant. He also says she is not interested in traveling or spending time with her friends, which she had previously said she wanted to do when she retired.

She has a past medical history of hypothyroidism, diagnosed at age 35 years, which has been well managed, and endometriosis, which improved after she had menopause in her early 50s.

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