A 22-year-old female is admitted to a 23-hour observation Unit with a Neurology and Psychiatry consultation ordered from the PCP

Case Study

A 22-year-old female is admitted to a 23-hour observation Unit with a Neurology and Psychiatry consultation ordered from the PCP.  She has a new-onset, “blurred vision and floaters.” The patient reported arising early morning of her admission with vision difficulty. Her neuro consult included full physical, imaging, and labs and showed no conclusive rationale for her abnormal presentation. She otherwise was healthy. 

You are the psychiatric provider and the patient explains, “I don’t know what is happening with my vision!” She migrated from Costa Rica four years ago, moving to the US in order to make a better life for her sick father, who was dying from cancer. He was sick for several months, but she failed short of sending money to support her father because of a gambling issue.  Her father died two months ago and she became disconsolate. 

Her MSE showed, OOOx4. Her hygiene and appearance are good, and she not overly concerned about vision changes. Her mood is, “OK,” full-range, and congruent. She presents with normal thought processes; denies S/I, H/I, or hallucinations. 

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