Chapter 5 Eyes & Ears

Case Study 1: Cataracts Patient: Mr. Thompson, a 72-year-old retired teacher, presents with gradually worsening vision in both eyes over the past year. He describes his vision as "cloudy," especially when driving at night. He notes increased sensitivity to light and frequent changes in his eyeglass prescription. Findings: • Visual acuity: 20/60 (both eyes) • Fundoscopy: Opacification of the lens • Slit-lamp exam: Bilateral nuclear sclerosis What is the most likely diagnosis?

• Glaucoma

• Cataracts

• Diabetic retinopathy

• Age-related macular degeneration

Case Study 1: Cataracts Patient: Mr. Thompson, a 72-year-old retired teacher, presents with gradually worsening vision in both eyes over the past year. He describes his vision as "cloudy," especially when driving at night. He notes increased sensitivity to light and frequent changes in his eyeglass prescription. Findings: • Visual acuity: 20/60 (both eyes) • Fundoscopy: Opacification of the lens • Slit-lamp exam: Bilateral nuclear sclerosis Which of the following symptoms is most characteristic of cataracts?

• Sudden vision loss

• Painless progressive blurry vision

• Halos with eye pain

• Distorted central vision

Case Study 1: Cataracts Patient: Mr. Thompson, a 72-year-old retired teacher, presents with gradually worsening vision in both eyes over the past year. He describes his vision as "cloudy," especially when driving at night. He notes increased sensitivity to light and frequent changes in his eyeglass prescription. Findings: • Visual acuity: 20/60 (both eyes) • Fundoscopy: Opacification of the lens • Slit-lamp exam: Bilateral nuclear sclerosis What is the definitive treatment for cataracts?

• Topical corticosteroids

• Surgical lens replacement

• Laser therapy

• Oral antibiotics

Case Study 1: Cataracts Patient: Mr. Thompson, a 72-year-old retired teacher, presents with gradually worsening vision in both eyes over the past year. He describes his vision as "cloudy," especially when driving at night. He notes increased sensitivity to light and frequent changes in his eyeglass prescription. Findings: • Visual acuity: 20/60 (both eyes) • Fundoscopy: Opacification of the lens • Slit-lamp exam: Bilateral nuclear sclerosis Which of the following is a known risk factor for cataract development?

• Hypothyroidism

• Long-term corticosteroid use

• Hyperkalemia

• Glaucoma medications

Patient: Ms. Lee, a 64-year-old woman, presents for a routine eye exam. She denies any visual complaints but has a family history of glaucoma. Her intraocular pressure (IOP) is 25 mmHg. Fundoscopic exam reveals increased cup-to-disc ratio. Findings: • IOP: Elevated • Optic disc: Cupping • Peripheral visual field: Reduced (on testing)

• Cataracts

• Diabetic retinopathy

• Open-angle glaucoma

• Retinal detachment

Patient: Ms. Lee, a 64-year-old woman, presents for a routine eye exam. She denies any visual complaints but has a family history of glaucoma. Her intraocular pressure (IOP) is 25 mmHg. Fundoscopic exam reveals increased cup-to-disc ratio. Findings: • IOP: Elevated • Optic disc: Cupping • Peripheral visual field: Reduced (on testing)

• A. Gradual loss of peripheral vision

• B. Central vision distortion

• C. Sudden eye pain

• D. Clouding of the lens

Patient: Ms. Lee, a 64-year-old woman, presents for a routine eye exam. She denies any visual complaints but has a family history of glaucoma. Her intraocular pressure (IOP) is 25 mmHg. Fundoscopic exam reveals increased cup-to-disc ratio. Findings: • IOP: Elevated • Optic disc: Cupping • Peripheral visual field: Reduced (on testing) What is the primary goal of treatment in open-angle glaucoma?

• Improve night vision

• Lower intraocular pressure

• Reverse optic nerve damage

• Reduce retinal swelling

Patient: Ms. Lee, a 64-year-old woman, presents for a routine eye exam. She denies any visual complaints but has a family history of glaucoma. Her intraocular pressure (IOP) is 25 mmHg. Fundoscopic exam reveals increased cup-to-disc ratio. Findings: • IOP: Elevated • Optic disc: Cupping • Peripheral visual field: Reduced (on testing)

• Prostaglandin analogs (e.g., latanoprost)

• Corticosteroid drops

• Antibiotic drops

• Anti-VEGF injections

Patient: Mrs. Greene, an 80-year-old woman, complains of difficulty reading and recognizing faces. She states that straight lines appear wavy. She has a history of hypertension and smoked for 30 years. Findings: • Amsler grid: Distorted lines (metamorphopsia) • Fundoscopy: Drusen bodies, macular changes • OCT: Subretinal fluid accumulation What is the most likely diagnosis?

• Diabetic retinopathy

• Glaucoma

• Age-related macular degeneration

• Retinal detachment

Patient: Mrs. Greene, an 80-year-old woman, complains of difficulty reading and recognizing faces. She states that straight lines appear wavy. She has a history of hypertension and smoked for 30 years. Findings: • Amsler grid: Distorted lines (metamorphopsia) • Fundoscopy: Drusen bodies, macular changes • OCT: Subretinal fluid accumulation Which part of the eye is primarily affected in macular degeneration?

• Optic nerve

• Lens

• Macula

• Cornea