DIAGNOSTIC QUIZ

After 6 Months of Blurred Vision,

Patient Says, ‘Enough Is Enough’

Andrew S. Gurwood, O.D.


A dilated fundus exam of a 57-year-old woman with a history of diabetes and hypertension revealed this presentation.

A 57-year-old woman presented with a chief complaint of blurry vision at distance and near for the past 6 months. Her ocular history was unremarkable for disease, injuries or surgeries. Her systemic history was positive for diabetes (15 years) and hypertension (10 years). She was also a cigarette smoker.

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Best-corrected visual acuities were 20/25 O.D., 20/40 O.S. at distance and near. The external examination was normal, with no evidence of afferent defect. Refraction revealed myopia with astigmatism and presbyopia. Biomicroscopy demonstrated normal anterior segment structures and open angles in both eyes. Goldmann applanation pressures measured 16mm Hg in both eyes. A dilated fundus exam revealed the presentation depicted in the photo.

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Answer

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