Classical eye signs in bacterial endocarditis

Abstract

### Learning point for clinicians Acutely unwell patients may present in wide range of ways. It is vital to recognize those critically unwell patients who present ambiguously. In this case report, a patient with life-threatening endocarditis presented to an eye casualty department with visual deterioration. A 21-year-old man presented to the eye casualty department via optician referral. He complained of loss of vision in his right eye 5 days previously. The optician queried a macular bleed and unilateral ‘papilloedema’ of the right eye. The patient gave a history of general malaise for a number of months with anorexia, headaches and weight loss over a period of weeks. It was noted that he had developed left facial weakness and dysarthria. He had a history of bicuspid aortic valve stenosis but did not attend for follow-up for the preceding 2 years. On general examination the patient appeared cachectic and anaemic. On ophthalmic examination, visual acuity was …