Central Carolina Surgical Eye Associates, P.A.
Case Six : Hypertensive Papillitis
Exacerbated by "Crack Cocaine" Abuse
Color fundus photo of the right eye reveals optic nerve  hyperemia, edema, peripapillary hemorrhages and hard exudate in the fovea Color fundus photo of the left optic nerve with severe edema, hard exudate and very narrowed vasculature.
Red free photo of the right eye highlights hemorrhages, edema and hard exudate. In the red free photo of the left eye the area of edema extends to the foveal region.
Early fluorescein angiogram (37.9 sec) of the left eye reveals patchy choroidal filling and hypertensive vascular changes. Late phase fluorescein angiogram (4 min. 53.5 sec) of the right eye shows diffuse leakage of fluorescein dye due to severe disc edema

Comments
This case is of a 47 y.o. B.M. with severe hypertension ( 247/147 ) complicated by polysubstance abuse. He is homeless and has left his hypertension untreated. His visual acuity was 20/80 in each eye two weeks after starting therapy for hypertension, when these photos were taken.

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