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emq 1.
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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.
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.