A 60-year-old female presents with painless, atraumatic vision loss in her left eye since last evening. The patient states that she initially experienced flashes of light and floaters in her eye, which progressed to vision loss. Initially, she lost vision in the periphery, like "a curtain coming down" over her eye. The vision loss then progressed centrally. A fundoscopic exam reveals a positive Schaffer's sign. What is the most likely diagnosis?

The most likely diagnosis is central retinal artery occlusion (CRAO). Symptoms such as flashes of light, floaters, and curtain-like vision loss are consistent with CRAO. Schaffer's sign is a positive finding that supports the diagnosis.

The most likely diagnosis for this patient is central retinal artery occlusion (CRAO). CRAO is a sudden blockage of the main artery of the retina, leading to vision loss. The symptoms described by the patient, such as flashes of light, floaters, and a curtain-like vision loss progressing centrally, are all consistent with CRAO.

Schaffer's sign is a visible whitening of the retina, which can occur in CRAO. This sign increases the likelihood of the diagnosis. It is important for the patient to seek immediate medical attention as CRAO is an ophthalmic emergency.

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