Clear Eyes, Full Hearts, Cleared To Play? - Page #1

Author: Ken Kenneth-Nwosa, MD
Co Author #1: Namita Bhardwaj, MD, CAQSM

Patient Presentation:
AD is a 15 year old male high school varsity athlete who presented to clinic for a pre-participation physical exam for the upcoming academic year. Patient is a varsity letterman in cross country and track. He is generally healthy, but does have a history of vision impairment in the right eye diagnosed at 2 years old after a failed vision screen. Original working diagnosis was amblyopia and he was given a patch to wear for a couple of years with corrective glasses. Patient began playing competitive baseball and was an elite pitcher during his early adolescent years. He did not wear protective eye gear or corrective lenses and had no limitations with playing. He ultimately stopped playing baseball due to personal reasons and switched to competitive running. During the exam he was found to have impaired visual acuity of the right eye while the left eye was within normal limits. Of note, he was diagnosed with ocular albinism in January 2009 and has consistently failed vision screens at previous school physicals and pediatrician offices. He no longer wears glasses nor wears protective eyewear during athletic competition. He found that corrective lenses did not make his eyesight better. He denies any reading difficulties, intermittent headaches, or eye pain. Patient denies recurrent infections or bleeding problems. There is no family history of albinism. Patient denies nystagmus. Patient takes OTC acne topical meds. There is no surgical history or traumatic injuries. There is no family history of eye diseases.

Ocular Albinism 2009
No Family History of Albinism or eye diseases No Surgical History

Physical Exam:
Vital signs were stable/normal. Patient was alert and oriented and in no acute distress. Snellen eye exam revealed a decreased visual acuity in the right eye, 20/70. There was no impairments in the left eye. Cardiopulmonary exam was within normal limits. Patient demonstrated a non-antalgic, normal gait. Upper and lower extremities demonstrated normal reflexes, range of motion and strength. There was no abnormal curvature of the back. Genitourinary exam exhibited Tanner Stage IV and no hernias were noted.

Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.

NOTE: For more information, please contact the AMSSM, 4000 W. 114th Street, Suite 100, Leawood, KS 66211 (913) 327-1415.

© The American Medical Society for Sports Medicine
4000 W. 114th Street, Suite 100
Leawood, KS 66211
Phone: 913.327.1415

Website created by the computer geek