QuestionSBA
QuestionChoice
Usually, patients have no visual symptoms at presentation with open-angle glaucoma, and it is mostly diagnosed through screening tests. A small proportion of patients may notice peripheral vision loss.
10005453
c
Primary open-angle glaucoma
QuestionChoice
Retinitis pigmentosa is a rare inherited condition causing retinal degeneration. Patients often present at a young age with 'tunnel vision' due to damage to the peripheral retina from pigment deposits.
10005455
e
Retinitis pigmentosa
QuestionChoice
A cataract refers to an opacity in the lens due to denatured protein. Presenting symptoms vary according to the type of cataract, but the most common at presentation are painless loss of vision, difficulty reading/watching television, difficulty recognising faces, faded colour vision as well as haloes and glare around lights, particularly at night. Steroids are a specific risk factor for subcapsular cataracts.
10005451
a
Subcapsular cataract
QuestionChoice
This can also present with glare. However, other symptoms that are typically reported include photopsia (perceived flickering of lights) and variability in visual disturbance from day to day.
10005452
b
Age-related macular degeneration (ARMD)
QuestionChoice
This would be very unusual to occur in someone with no past medical history of diabetes.
10005454
d
Diabetic retinopathy
Concept
Chapter
2693
4409
Ocular side effects of steroids
Topic
140
Ophthalmology
13637
A 50-year-old woman attends her optician complaining of gradual onset noticeable fading of her colour vision as well as glare from headlights when driving in the dark. She says her symptoms do not change day to day and are getting gradually worse. She has a past medical history of polymyalgia rheumatica for which she has been using long-term prednisolone to treat. Her pupils are dilated and ophthalmoscopy is undertaken which reveals a normal fundus and optic nerve.

Which of the following is the most likely diagnosis?
a