Rapid Diagnosis in Ophthalmology Series- Neuro-Ophthalmology-0323044565
Case Studies in Ophthalmology WUMS 3
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Transcript of Case Studies in Ophthalmology WUMS 3
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Case Studiesin
OphthalmologyWUMS 3
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60 y/o woman complains of fatigue and slight decreasein vision. Both eyes similar.
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55 WM has had occipital headaches in themorning for several months...mild visual blur...both eyes similar.
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22 woman has had “pink eye” for 2 days, &the other eye is now involved. Take a history.
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60 AAF with painless unilateral progressive visual loss over the past several months.Concentrate on the disc color...what is yourassessment ? .
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Diagnosis ?
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You try to do routine ophthalmoscopyon this 80 y/o patient. Why are you unable
to see the disc and retinal vessels ?
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50 y/o with severe headaches for 3 daysawoke this morning with diplopia. We have asked the patient to look up. The rightpupil is dilated. Your assessment ?
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35 AAF admitted to Infectious Disease Dept.for workup for an “incidental finding”on a routine chest x-ray. She admits to “blurry” vision and photophobia O.U.
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75 WF with acute severe loss of vision in one eye yesterday. She admits to “soreness” in her shoulderfor months as well as headaches.
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25 y/o woman. Concentrate on the disc. Whatquestions should you ask when taking the clinical history;e.g. systemic findings? Unilateralvs. bilateral ? Visual loss ?
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55 y/o healthy AAM for a “routine”annual P.E. He is completely asympt-omatic. Why should you refer pt. toan ophthalmologist ?
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80 y/o for his semi-annual P.E. His HTNhas been controlled, and his only complaint is “distortion” of central vision O.U. Yourassessment ?
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65 y/o with HTN, hx of “heart attack “, hadacute, painless, complete loss of vision in oneeye 2 hours ago. Your assessment & plan for management.
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This 80 y/o man has been aware of this lesion for over a year.
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65 y/o for “routine” follow up P.E. ThePatient has HTN and possible TIA in the past. Your assessment & plan ?
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The parents have been told that their childwill “outgrow” the appearance the eyes. Doyou agree, or should you refer to an ophthal-mologist ?
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40 y/o man admitted to Infectious DiseaseDivision with high fever, visual loss O.U. YourAssessment & plan ?
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The parents are concerned that their child’s eye
looks abnormal. Do you: A.Tell parents that there is nothing to worry
aboutB. Refer immediately to an ophthalmologist
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clueless ?Match these answers to the photos:
Nonproliferative diabetic retinopathyHypertensive retinopathyConjunctivitis vs. iritis vs. foreign body vs. corneal abrasionOptic nerve atrophy (ischemic ? inflammatory ? neoplasm ? )Grave’s ophthalmopathyCataractThird nerve palsySarcoid iritisGiant cell arteritisPapilledema vs. papillitisGlaucomatous cuppingAge related macular degenerationCentral retinal artery occlusionBasal cell carcinomaEmbolus: look for the source e.g. carotid a.StrabismusCMV retinitis in AIDSRetinoblastoma