{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:41:07Z","timestamp":1772152867202,"version":"3.50.1"},"reference-count":6,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2023,12,28]],"date-time":"2023-12-28T00:00:00Z","timestamp":1703721600000},"content-version":"unspecified","delay-in-days":27,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,11,30]]},"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:p>An elderly man with recurrent syncope was admitted with a globe rupture following a syncopal attack. After an initial unremarkable evaluation, the patient reported inversion of the room\u2019s wall clock during a bedside evaluation. This symptom is called reversal-of-vision metamorphopsia (RVM) and is a rare visual disturbance that typically results from organic processes localised to the retina and\/or posterior cortex of the brain or in some cases is psychogenic in nature. In this case, both the syncope and RVM were caused by impaired circulation in the posterior cortex, and management included an antiplatelet agent, statin and permissive blood pressure targets, which resulted in the correction of RVM.<\/jats:p>","DOI":"10.1136\/bcr-2023-255453","type":"journal-article","created":{"date-parts":[[2023,12,28]],"date-time":"2023-12-28T12:10:23Z","timestamp":1703765423000},"page":"e255453","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Turning the world upside down: reversal-of-vision metamorphopsia in a patient with syncope"],"prefix":"10.1136","volume":"16","author":[{"given":"Cassandra","family":"Mullen","sequence":"first","affiliation":[{"name":"Oregon Health & Science University, Portland, Oregon, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zachary","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Oregon Health & Science University, Portland, Oregon, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Pettersson","sequence":"additional","affiliation":[{"name":"Oregon Health & Science University, Portland, Oregon, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan","family":"Hunter","sequence":"additional","affiliation":[{"name":"Oregon Health & Science University, Portland, Oregon, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,12,28]]},"reference":[{"key":"2025082708553403000_16.12.e255453.1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.55.10.1362"},{"key":"2025082708553403000_16.12.e255453.2","doi-asserted-by":"crossref","DOI":"10.1136\/bmjno-2022-000337","article-title":"Upside-down vision: a systematic review of the literature","volume":"4","author":"Yap","year":"2022","journal-title":"BMJ Neurol Open"},{"key":"2025082708553403000_16.12.e255453.3","doi-asserted-by":"publisher","DOI":"10.1177\/1352458507082045"},{"key":"2025082708553403000_16.12.e255453.4","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1016\/j.yebeh.2005.08.012","article-title":"Reversal of vision metamorphopsia: a manifestation of focal seizure due to cortical dysplasia","volume":"8","author":"Unal","year":"2006","journal-title":"Epilepsy Behav"},{"key":"2025082708553403000_16.12.e255453.5","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1097\/00041327-200306000-00051","article-title":"Video electroencephalogram monitoring during paroxysmal upside down reversal of vision","volume":"23","author":"Gondim","year":"2003","journal-title":"J Neuroophthalmol"},{"key":"2025082708553403000_16.12.e255453.6","doi-asserted-by":"crossref","DOI":"10.1136\/jnnp.56.4.423","article-title":"Acute upside down reversal of vision in vertebrobasilar ischaemia","volume":"56","author":"Stracciari","year":"1993","journal-title":"J Neurol Neurosurg Psychiatry"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2023-255453","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T15:55:41Z","timestamp":1756310141000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2023-255453"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12]]},"references-count":6,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2023,12,28]]},"published-print":{"date-parts":[[2023,12]]}},"alternative-id":["10.1136\/bcr-2023-255453"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2023-255453","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12]]}}}