Description
A 71 year old man was referred to the Eye Out-patient
Department of NHS Grampian with a 3 week history
of vertical diplopia. He had a complex medical history
including angina pectoris, essential hypertension, stroke
and previous left central retinal vein occlusion resulting
in blindness in that eye. He was on warfarin, pravastatin
and anti-hypertensive medication. Biochemical investigation
6 months prior to eye out-patient referral showed
mild renal impairment with marginally elevated serum
urea [8.5 mmol/L (ref. range 3.4 – 7.0 mmol/L)] and
creatinine [128 μmol/L (ref. range 60 – 110 μmol/L)]
levels commensurate with stage 3 chronic kidney disease
(eGFR 5 52 ml/min). No haematological abnormalities
were observed at this time.
