A 7-year-old Arabic girl presented to the emergency department with acute vision loss in the left eye that began that morning.

She had a history of type 1 diabetes, strabismus, amblyopia with left intermittent exotropia and pathologic myopia. She denied any other ocular or systemic symptoms. Her family history included pathologic myopia. Her neonatal, surgical, medication and developmental histories were non-revealing. She was born in Morocco, and she received low vision services and used a magnifier at school.

Figure 1. A photographic image of the patient’s patch of alopecia on her occipital scalp.

Source: Virali Shah, MD, and Shilpa Desai, MD

Examination

On examination, the patient presented to the emergency department with the following vital signs: temperature of 36.8°C, heart rat

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