A 55-year-old woman comes to the optician complaining of a gradual decrease in her visual acuity. Upon examination, the optician refers her for medical evaluation. The fundoscopic exam reveals:
Based on the fundoscopic findings, what is the most suitable course of treatment?
As part of a routine health checkup, a 75-year-old man undergoes an eye examination using retinal photography. The following image is observed:
The patient reports experiencing reduced visual acuity and occasional double vision. He is currently taking several medications, including amlodipine, losartan, salbutamol, metformin, paracetamol, and codeine.
Based on the provided photo, what is the most probable diagnosis?
A 40-year-old man presents to the ophthalmology clinic with a history of vague vision problems. He has not sought medical attention in years and denies any medical illness.
Upon fundoscopic examination, the following findings were observed:
What is the probable underlying cause of these fundoscopic findings?
A 30 year-old woman comes to the clinic complaining of double vision that has been present for two months and worsens towards the end of the day. Upon examination, bilateral ptosis is observed, which is fatigable. There is a complex ophthalmoplegia that does not follow the pattern of one or more cranial nerves. The limbs show no abnormalities.
What finding would strongly indicate a diagnosis of myasthenia gravis in this patient?
A 65-year-old woman presents with a three-month history of diplopia and blurred vision in her left eye. She reports no pain or other neurological symptoms and has no significant medical history except for smoking 20 cigarettes per day and drinking alcohol in moderation.
During her examination, her right eye has a visual acuity of 6/6 while her left eye is only 6/36. She has left partial ptosis and mild proptosis with conjunctival injection. The left pupil is smaller than the right but reacts normally to light. There is some limitation of abduction of the left eye, and fundoscopy reveals a pale left optic disc. The left corneal reflex is reduced, but the remainder of her neurological examination is normal.
Routine blood tests, including a full blood count, urea and electrolytes, liver function tests, thyroid function, serum calcium, serum creatine kinase, and autoantibody screen, were all normal. Her electrocardiogram and chest radiograph showed no abnormalities. Slit lamp examination was normal, and intraocular pressures were within the normal range.
Based on these findings, where is the most likely site of the lesion causing her symptoms?
A 65-year-old man presents with sudden painless diplopia that has been present for the past five days. He reports no weakness in his body and his visual acuity is 6/6 in both eyes according to the Snellen chart. Upon examination, he displays variable horizontal and vertical diplopia in both right and down gaze, as well as bilateral ptosis. The pupils are equal and reactive to light and accommodation, and there is no proptosis or discoloration of the eyes. What is the most likely diagnosis?
A 57-year-old man presents to the clinic with complaints of blurred vision and drooping of his left eyelid for the past three weeks. He has a history of hypertension and hyperlipidaemia, which were diagnosed two years ago, and he currently takes lisinopril and atorvastatin. The patient has been a heavy smoker for the past 30 years.
During the physical examination, the patient’s vital signs are normal, and his pupils and eye movements appear normal. The drooping resolves after closing his eyes for five minutes, but it recurs and worsens progressively after a few minutes. The patient’s cardiovascular, respiratory, and neurological examinations are unremarkable.
What is the most appropriate next step in managing this patient?
A 50-year-old man with a history of type II diabetes mellitus presents for his regular diabetic eye screening. He states that he has been taking his diabetes medications as prescribed. Upon fundoscopy, the following was observed:
What would be the best course of action for managing this patient?
A 72-year-old man comes to the clinic with a sudden painless loss of vision in his left eye. Upon fundoscopy, the following is observed:
What is the probable diagnosis?
A 56-year-old woman with type 2 diabetes mellitus has been referred to the Diabetic Clinic by her GP due to difficulty in reading small print that has gradually developed over several months. She has been managing her diabetes with diet alone for the past 11 years, but is obese and smoking 15 cigarettes a day. Her medical history includes hypertension and hyperlipidaemia, and she takes atenolol 50 mg od. On examination, her blood pressure was 135/85 mmHg and her pulse was 66 bpm and regular. Fundoscopy reveals NPDR. Her FBC and U/Es are normal, and her HbA1c was 63.93 mmol/mol (8.0%). What is the expected outcome if drug treatment is initiated instead of diet management in this patient?