Case 2
A 65-year-old woman attends the ED complaining that she has suddenly lost vision in her left eye. She normally wears glasses for reading and driving, has had no previous eye problems and takes a diuretic for hypertension.
You start to assess this patient’s visual acuity. Unfortunately she has only brought her reading glasses with her.
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Question 1 of 3
1. Question
Put the following in order, assuming that, at each stage, the examination is negative.
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- Step 1
- Step 2
- Step 3
- Step 4
- Step 5
- Step 6
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Read letters on a chart at 6m
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Read letters on a chart at 3m
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Differentiate hand movements
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Count fingers
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Read letters on chart at 6m with pinhole occluder
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Perceive light
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Question 2 of 3
2. Question
Next, you assess the pupil reflexes and perform the swinging light test. Describe what happens:
- In a normal reaction
- In an abnormal response
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Question 3 of 3
3. Question
Match each diagnosis to the appropriate pupil reaction.
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- Constricted pupil; reacts to accommodation, not to light
- Dilated pupil; no reaction to light or accommodation
- Constricted pupil; reacts to light and accommodation
- Dilated pupil; reacts to accommodation, not to light
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Argyll-Robertson pupil
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Oculomotor nerve palsy
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Horner's syndrome
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Holmes-Adie syndrome
CorrectIncorrect