A 24 year-old male presents to the emergency department for evaluation of an eye injury with loss of vision. The patient states he was playing soccer last night when the ball struck him in the face injuring his left eye. There was no loss of consciousness. The patient described some blurriness and loss of peripheral of vision last night after the accident, but awoke this morning to find he could not see out of his left eye. He denies and headache or neck pain and has no history of previous left eye trauma or surgery. The patient’s visual acuity exam revealed 20/25 in the right unaffected eye, and light perception only in the left eye. He does appear to have a relative afferent pupillary defect of the left eye. He has no proptosis or ptosis. His extraocular movements are intact and he denies any orbital rim tenderness or infraorbital parasthesias. You perform a fundoscopic exam.
1. What does this fundoscopic exam reveal?
2. What should also be included in your physical exam?
3. What is your next diagnostic step?