Case Rep@l!'t A 39 year old Malay clerk, at the 30th week of gestation of her fourth uncomplicated pregnancy presented with two weekS history of blurring of left central vision, preceded by some form of emotional stress. She was very stressed that she could not perform her daily clerical work as before. She had no history of pregnancy induced hypertension in the past. General examination revealed a young healthy lady, normotensive and not anaemic. The cardiovascular and respiratory systems were

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... also normal. The abdominal examination was consistent with a 30 weeks gravid uterus. There was no evidence of proteinuria. Ocular examination revealed right visual acuity of 6/5 and left visual acuity of 6/6. The near vision for the right and left eye was N5 and NIO respectively. Both pupils were reactive briskly ro light with no relative afferent pupillary defect. The Amsler grid examination of the left eye revealed the presence of shadow and distorted lines however, there was no abnormality in the right eye. Fundoscopy of the left eye using quadraspheric contact lens revealed a shallow elevation of the sensory retina at the macular region with well-defined border outlined by a glistening ring reflex. There was no evidence of retinal Med J Malaysia Vol 53 No 4 Dec 1998 pigment epithelium detachment or evidence of subretinal neovascular membrane. The foveal reflex was absent. This is illustrated in Figure l. The right fundus was normal. 439