A 40-year-old type 1 diabetic undergoes fundoscopy as part of his annual follow-up. His HbA1c is 9.5% (81 mmol/mol). Fundoscopy reveals haemorrhages, cotton-wool spots and the presence of new vessels.
What is the next step in his management?
A 16-year-old male comes to the clinic complaining of an itchy eye with watery discharge on one side. The patient reports feeling generally healthy, without changes to their vision or fever symptoms. They wear contact lenses but have not had an optician appointment recently.
During the examination, the patient’s right eye shows injected conjunctiva, but there is no noticeable swelling or redness around the eye. The application of topical fluorescein does not reveal any corneal staining.
What would be the best course of action for managing this patient’s symptoms?
A 42-year-old man visits his doctor complaining of deteriorating vision. He states that his vision has been getting blurrier, particularly when reading. He denies experiencing any eye pain, redness, double vision, or other systemic symptoms. Upon examination, his visual acuity is measured using a Snellen chart and found to be 6/12 in both eyes. What is the most appropriate course of action to investigate a possible refractive error?
A 65-year-old man visits the clinic with complaints of vision problems that have persisted for the past month. He reports difficulty reading words in books and blurry vision. The patient’s visual acuity is 20/30 in both eyes upon examination. He currently takes amlodipine and ramipril for hypertension and smokes 30 cigarettes per day. The patient is concerned about losing his vision, as his father experienced a similar issue.
During fundoscopy, amber material deposits are observed under the retinal pigment epithelium in both eyes, without neovascularisation present. What is the most appropriate next step in diagnosing the patient’s condition?
A 75-year-old female comes to her doctor complaining of sudden left shoulder and arm pain that has been getting worse over the past week. The pain is now unbearable even with regular co-codamol. During the examination, the doctor observes that the patient’s left pupil is smaller than the other and the eyelid is slightly drooping. What question would be most helpful in determining the diagnosis for this woman?
A 45-year-old man comes to the eye clinic complaining of bilateral redness around the corneal limbus. He has been experiencing this for one day and is in a lot of pain, particularly when reading the newspaper. He also reports sensitivity to light and blurry vision. Additionally, he has a headache that is affecting his entire head and back pain that is more severe in the morning but improves throughout the day.
During the examination, the patient’s pupils are fixed and small, with an oval shape. There is no hypopyon, but his eyes are very watery.
What is the most appropriate course of action for managing this patient’s symptoms?
An 80-year-old man arrives at the emergency department with a complaint of severe headache. He has a medical history of hypertension and takes Ramipril 10 mg and Amlodipine 10 mg. During the full workup, fundoscopy is conducted and reveals scattered cotton wool spots, tortuous vessels throughout, and AV nipping in both eyes. According to the Keith-Wagener classification, what stage of hypertensive retinopathy does this patient have?
A 15-year-old boy arrives at the emergency department complaining of a severe headache. He has been experiencing this headache for the past 4 hours and has noticed that lights appear brighter and hurt his eyes. The boy is unable to touch his chin to his neck due to pain. Upon examination, there are no neurological deficits, but papilloedema is observed during fundoscopy. No rash is detected during the examination. The boy’s early warning score is 1 due to a raised temperature, but otherwise, he is stable.
What is the most appropriate course of action for managing this patient’s presentation?
A 29-year-old individual arrives at the emergency department complaining of sensitivity to light and a red right eye that began an hour ago. Upon examination, the right eye is painful, red, and has an irregularly-shaped pupil, while the left eye appears normal. The patient is referred to ophthalmology for further evaluation. What is the probable medical treatment that the patient received?
A 68-year-old woman comes to the Ophthalmology Clinic complaining of decreased vision in her right eye for the past 2 weeks. She reports seeing wavy lines and experiencing blurred vision in the centre of her right eye. She denies any pain in either eye. Upon fundoscopic examination, the doctor observes a greyish-green discolouration of the retina and subretinal exudate. Fluorescence angiography reveals neovascularisation and exudation in the macular region. What is the initial treatment option for this patient?