nbme12, directly helps answer the Q:
An 87-year-old man comes to the physician because of a 2-day history of visual changes in his right eye. He notices that the lines of his daily crossword puzzle look curved, and the blinds in his apartment appear wavy. There is no pain in his eye, no photophobia, and no history of trauma to the area. He had cataract removal from the right eye 5 years ago. On examination, visual acuity is 20/200 in his right eye and 20/100 in his left eye. The right pupil is irregular, but it is reactive to light. The left pupil is round and reactive. This examination finding is unchanged since his cataract operation. Palpation of both globes through closed eyelids shows no abnormalities. His lenses appear clear. Which of the following is the most appropriate next step in diagnosis?
Ans: Dilated funduscopic examination
Age-related macular degeneration (AMD) is an acquired retinal degeneration, the diagnosis is established with a dilated funduscopic examination.
{{c1::Macular degeneration}}
- Fundoscopic examination may reveal drusen deposits in the macula
- Imagine a wave of big Macs floating toward you; also think of needing a centrally-located macula for fine visual acuity (e.g., visualization of straight lines)
Photo Credit: Jmarchn, CC BY-SA 3.0, via Wikimedia Commons
Photo Credit: US gov, Public domain, via Wikimedia Commons
Dry macular degeneration image featuring drusen. Photo credit: Jmarchn, CC BY-SA 3.0, via Wikimedia Commons
Watch Age-Related Macular Degeneration
