QuestionSBA
QuestionChoice
This is another cause of painless visual loss, but involves the cornea and typically presents with blurred vision first thing in the morning when a patient wakes up.
10005443
c
Fuch's endothelial dystrophy
QuestionChoice
This is a typical presentation of dry age-related macular degeneration. Symptoms typically include reduced visual acuity, worse with near vision, variability in visual disturbance from day to day, poor vision at night, photopsia (perceived flickering of lights), and glare. Drusen is seen in dry ARMD as yellow pigmented spots on the retina that are collected around the macula.
10005441
a
Age-related macular degeneration (ARMD)
QuestionChoice
This is a potential cause of painless visual loss, but drusen would not be seen on fundoscopy.
10005442
b
Refractive error
QuestionChoice
This is another cause of painless visual loss but usually presents with complaints of photopsia and floaters.
10005445
e
Vitreous haemorrhage
QuestionChoice
This is another cause of painless visual loss but usually patients have no visual symptoms at presentation and glaucoma is mostly diagnosed through screening tests. Fundoscopic/slit-lamp assessment of patients with open-angle glaucoma may reveal a pale optic disc (indicating optic nerve atrophy), optic disc cupping (a cup:disc ratio of >0.7), or retinal vessel 'bayonetting' (when vessels appear to have a break as they enter the deep cup and then reappear at the base).
10005444
d
Primary open-angle glaucoma
Concept
Chapter
2693
4407
Age-related macular degeneration
Topic
140
Ophthalmology
13635
A 78-year-old female smoker attends her optician with gradually worsening painless visual loss, especially for near objects. She also reports that her vision in dim light is especially worse. The optician performs fundoscopy, which reveals the presence of drusen.

Which of the following is the most likely diagnosis?
a