Case 43 
History: This 23 year-old man was referred by his optician because of bilateral optic disc swelling. 
His vision was 6/9 in both eyes and the patient complained of being unwell for the past 3 months
and suffered with intermittent blurred vision. His blood pressure measured 220/130. He was referred
to the neurologist on-duty. An urgent CT scan shows no evidence of space-occupying lesion. 
His routine blood test showed normochromic normocytic anaemia and raised urea and creatinine
consistent with chronic renal failure. Renal scans revealed shrunken kidneys probably secondary
to damage from recurrent ureteric reflux. The blood pressure was controlled with medication and
he received haemodialysis. The optic disc swelling resolved when he was seen again at two-month 
ocular review.

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