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Grand Rounds Case #77- Dizziness and vertigo at time of exam |
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Case History:
This is 64 year old male of Indian descent presents to my clinic for a baseline diabetic eye examination and refraction. As soon as the patient had completed his entrance visual acuites and while sitting in an examination chair, the patient immediately experienced vertigo and nausea. He vomited.
The patient had complained about this same problem just 3 days before. He does have a history of Type 2 Diabetes (Glucophage, 500mg, BID) and hypertenison. He is experiencing no pain of any kind.
The patient denies any history of alcohol, tobacco or illicit drug use.
The pre testing was as follows:
1. Entrance Vision OD 20/25 and OS 20/30 with current glasses
2. RPG (Random Plasma Glucose) 182
3. BP 100/60. Pulse 74 and regular. Body Temp afebrile
4. O2 saturation at room temperature is 100%
5. The patient is unable to hear a ticking watch in one of the ears but is able to hear on the
contra lateral ear.
Questions:
1. Is the patient capable of continuing the eye examination?
2. Is the loss of hearing in one ear related to the vertigo?
3. How would you manage this patient.
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