A 21-year-old female presented with dimness of vision, more at night, for the past 12 months. On examination, her best corrected vision was 6/6 in the right eye and 6/9 in the left eye. Fundus examination revealed pale discs, attenuated vessels with periarteriolar sheathing, and numerous yellow-white scattered lesions and bony spicule pigmentary lesions in the peripheral retina of both eyes. The provisional diagnosis was retinitis punctata albescens with myopia.

1. Dr.Puskar Ghosh
3rd yr PGT,Dept. of Ophthalmology
Burdwan Medical College

2.  Name: Hasiba Khatoon
 Age:21 yrs,(married)
 Sex: Female
 Address: Sakta, Burdwan
 Chief complaints: Dimness of vision at night for last twelve months.
 History of present illness: the patient stated that she noticed the
problem 12 months back while doing indoor works at night.First
there was dimness of vision at night only , she felt that it would be
better if there was more light . Then the difficulty begins from the
sun set times. Now she is having problem in vision in the dark room
even in the day time.She attended local PHC and took medicines and
Vitamin oil occasionally but without any result. She had not attended
any eye clinic before. There was no difficulties in vision in daylight.
 There was no H/O pain, redness, watering or photophobia, floaters
or flash of light. There was no H/O any eye injury.
 There was no H/O deafness or indigestion.

3.  Past History: No significant past history of illness.There was no H/O
diabetes or hypertension.No H/O any prolonged drug intake.
 Personal history: There was no H/O any addiction.
 Family History: No family history of nightblindness.
 Treatment History:nothing significant

4.  EXAMINATION:
 A.GENERAL SURVEY:
 Pt was alert,concious,co operative.
• Facies-Normal
• Decubitus- of choice
• Pallor- absent
• Cyanosis,-absent
• Icterus-Absent
• Clubbing-absent
• Oedema-absent
• Neck vein-not engorged
• Neck glands-not palpable
• Pulse-84/min
• BP-110/80mmHg.

5. OD OS
Visual Acuity
1.UCVA-
2.BCVA-
6/12
-0.75DS (6/6)
6/18
-1DS (6/9 part)
Colour Vision Normal Normal
Ocular Movements Full in all gazes Full in all gazes
Eyeball
1. Position-
2. Size-
Normal
Normal
Normal
Normal

6. OD OS
Lid Normal Normal
Globe & adnexa Normal Normal
Conjunctiva Normal Normal
Cornea Transparent Transparent
Corneal sensation
+
+ +
+
+
+ +
+
Anterior chamber Normal depth,clear Normal depth,clear
Iris-
1. Colour-
2. Texture-
Brown
Normal
Brown
Normal

7. OD OS
Pupil-
1. Size-
2. Shape-
3. Position-
4. Reactions-
3mm
Circular
Central
Direct +,Consensual +
3mm
Circular
Central
Direct +,Consensual +
Gonioscopy
CBB
CBB CBB
CBB
CBB
CBB CBB
CBB
AT (12.6.15 at
11:15am)
12mm Hg 14 mm Hg

8. OD OS
Media Clear Clear
Disc-
1. Size:
2. Shape:
3. Colour:
4. Margin:
5. NRR:
Normal
Normal
Pale
Well delineated
Pale
Normal
Normal
Pale
Well delineated
Pale
Macula Dull foveal reflex Dull foveal reflex
Vesseles Peripheral attenuation
sheathing
Peripheral attenuation
Sheathing

9. OD OS

10. Numerous scattered yellowish white lesions and few bony spicule
pigmentary lesions in the peripheral retina of both eyes.
Posterior and peripheral Retina:

11.  Summery:
20year old Hasiba Khatoon presented with
dimness of vision,more at night for last 1year.She
had no significant past history and no family history
of such problem.
On general examination,within normal limit.
On ocular examination,she had BCVA and normal
anterior segment of both eyes.
Posterior Segment examination of both eyes shows
pale disc,few attenuated vesels along with
periarteriolar sheathing more in the peripheral
retina,dull foveal reflex and neumerous yellowish
white scaterred lesion with few bony spicule
pigmentary lesions in the peripheral retina.

12. Provisional Diagnosis:
 Retinitis Punctata albescens with myopia in a
21yrs old female patient.

13. THANK YOU