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Case Studies in Ophthalmology WUMS 3

Case Studies in Ophthalmology WUMS 3. 60 y/o woman complains of fatigue and slight decrease in vision. Both eyes similar. 55 WM has had occipital headaches in the morning for several months...mild visual blur... both eyes similar. 22 woman has had “pink eye” for 2 days, &

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Case Studies in Ophthalmology WUMS 3

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  1. Case Studies in Ophthalmology WUMS 3

  2. 60 y/o woman complains of fatigue and slight decrease in vision. Both eyes similar.

  3. 55 WM has had occipital headaches in the morning for several months...mild visual blur... both eyes similar.

  4. 22 woman has had “pink eye” for 2 days, & the other eye is now involved. Take a history.

  5. 60 AAF with painless unilateral progressive visual loss over the past several months. Concentrate on the disc color...what is your assessment ? .

  6. Diagnosis ?

  7. You try to do routine ophthalmoscopy on this 80 y/o patient. Why are you unable to see the disc and retinal vessels ?

  8. 50 y/o with severe headaches for 3 days awoke this morning with diplopia. We have asked the patient to look up. The right pupil is dilated. Your assessment ?

  9. 35 AAF admitted to Infectious Disease Dept.for workup for an “incidental finding” on a routine chest x-ray. She admits to “blurry” vision and photophobia O.U.

  10. 75 WF with acute severe loss of vision in one eye yesterday. She admits to “soreness” in her shoulder for months as well as headaches.

  11. 25 y/o woman. Concentrate on the disc. What questions should you ask when taking the clinical history;e.g. systemic findings? Unilateral vs. bilateral ? Visual loss ?

  12. 55 y/o healthy AAM for a “routine” annual P.E. He is completely asympt- omatic. Why should you refer pt. to an ophthalmologist ?

  13. 80 y/o for his semi-annual P.E. His HTN has been controlled, and his only complaint is “distortion” of central vision O.U. Your assessment ?

  14. 65 y/o with HTN, hx of “heart attack “, had acute, painless, complete loss of vision in one eye 2 hours ago. Your assessment & plan for management.

  15. This 80 y/o man has been aware of this lesion for over a year.

  16. 65 y/o for “routine” follow up P.E. The Patient has HTN and possible TIA in the past. Your assessment & plan ?

  17. The parents have been told that their child will “outgrow” the appearance the eyes. Do you agree, or should you refer to an ophthal- mologist ?

  18. 40 y/o man admitted to Infectious Disease Division with high fever, visual loss O.U. Your Assessment & plan ?

  19. The parents are concerned that their child’s eye • looks abnormal. Do you: • Tell parents that there is nothing to worry about • B. Refer immediately to an ophthalmologist

  20. clueless ? Match these answers to the photos: Nonproliferative diabetic retinopathy Hypertensive retinopathy Conjunctivitis vs. iritis vs. foreign body vs. corneal abrasion Optic nerve atrophy (ischemic ? inflammatory ? neoplasm ? ) Grave’s ophthalmopathy Cataract Third nerve palsy Sarcoid iritis Giant cell arteritis Papilledema vs. papillitis Glaucomatous cupping Age related macular degeneration Central retinal artery occlusion Basal cell carcinoma Embolus: look for the source e.g. carotid a. Strabismus CMV retinitis in AIDS Retinoblastoma

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