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A 26-year-old man presented to the ophthalmology clinic with sudden painless diminution of vision of both eyes for last 3 days. His corrected visual acuity was 20/200 in right eye and 20/400 in left eye. Fundoscopic examination (figure 1) showed grade IV hypertensive retinopathy with soft exudates (blue arrow), hard exudates (black arrow), macular star (white arrow) and papilledema (blue arrowhead). Retinal oedema and haemorrhages were seen (white arrowhead), along with arterio-venous crossing changes in the form of Gunn sign (black arrowhead).
RK and AK are joint first authors.
Contributors RK and SS: worked up the case, took the photographs and wrote the manuscript. AK and VG: involved in clinical management and final review of manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.