THE WRITTEN EMERGENCY MEDICINE FELLOWSHIP COURSE

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emq 1.

Match each clinical vignette to the most appropriate diagnosis.

Angle closure glaucoma
Temporal lobe CVA
Central retinal vein occlusion
Acute iritis
Bacterial conjunctivitis
Open angle glaucoma









Viral conjunctivits
Occipital CVA
Retinal detachment
Central retinal artery occlusion
Bacterial keratitis
Parietal lobe CVA
1. A 35 year old woman with a history of quiescent Crohn’s disease presents complaining of excessive tearing and pain to the left eye. Her visual acuity is 9/6 on the left and 5/6 on the right. On examination she has pronounced inflammation of the sclera which intensifies near the corneal border.

2. A 28 year old man with a history of active Ulcerative Colitis presents to the emergency department complaining of a painful, “grainy” left eye. His visual acuity is 9/6 on the left, corrected to 6/6 with pinhole testing. On examination he has significant scleral injection without any exudate, most pronounced at the margins of the eye.

3. A 44 year old woman presents to the emergency department complaining of painless loss of vision in her left eye. She had laser surgery to correct a refractive error to the eye 2 years previously. She describes “floaters” in her vision followed by a curtain descending down across her eye. On examination she has a visual field defect in both upper quadrants as well as an afferent pupillary defect. 

4. A 60 year old patient presents to the emergency department with painless loss of vision in her right eye. She has a history of atrial fibrillation. On examination visual acuity in the eye is limited to inaccurate finger counting and there is an afferent pupillary defect. Fundoscopy reveals a pale swollen optic disc surrounded by splinter haemorrhages.

5. A 71 year old woman with a history of atrial fibrillation presents complaining of visual disturbances. She has no pain in either eye. On examination she has a left sided homonymous hemianopia, with some macular sparing.



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