20/09/2024 – Special senses

Question Easy:
A 25-year-old man presents to the clinic with complaints of sudden loss of vision in one eye, pain with eye movement, and perception of flashing lights. He reports that he experiences a sensation as though a curtain is coming down over his field of vision. Which of the following is the most likely diagnosis? 😢

A) Retinal detachment
B) Glaucoma
C) Cataract
D) Macular degeneration
E) Conjunctivitis

Explanations & Answers:

Question Easy Answer:
A) Retinal detachment

Question Easy Explanation:
The description of sudden vision loss, pain with eye movement, flashing lights, and a curtain-like shadow descending over the visual field are characteristic symptoms of retinal detachment. Prompt referral to an ophthalmologist is essential.

Question Medium:
A 60-year-old woman is diagnosed with age-related macular degeneration (AMD). She is worried about her vision deteriorating further. Which of the following interventions is most likely to reduce the progression of dry AMD according to NICE guidelines?

A) Intravitreal injections of anti-VEGF
B) High-dose antioxidant vitamins and minerals
C) Laser photocoagulation
D) Cataract surgery
E) Prophylactic antibiotic eye drops

Explanations & Answers:

Question Medium Answer:
B) High-dose antioxidant vitamins and minerals

Question Medium Explanation:
NICE guidelines recommend that high-dose antioxidant vitamins and minerals can slow the progression of dry age-related macular degeneration. Intravitreal injections of anti-VEGF are primarily used for the neovascular (wet) form of AMD.

Question Hard:
A 45-year-old man presents with rapidly progressive hearing loss, vertigo, tinnitus, and sensations of aural fullness. An MRI reveals a well-defined cerebellopontine angle mass. Which is the most likely diagnosis?

A) Acoustic neuroma
B) Meniere’s disease
C) Vestibular neuronitis
D) Otosclerosis
E) Labyrinthitis

Explanations & Answers:

Question Hard Answer:
A) Acoustic neuroma

Question Hard Explanation:
An acoustic neuroma, or vestibular schwannoma, is a benign tumor that can cause unilateral sensorineural hearing loss, vertigo, tinnitus, and aural fullness. The cerebellopontine angle mass noted on MRI confirms this diagnosis, necessitating a multidisciplinary approach overseen by neurologists and ENT specialists.

Medical fact of the day:
Macular degeneration is the leading cause of blindness in adults over 50 years old in the UK, affecting around 600,000 people. Early detection and treatment can significantly slow the progression of this condition.

Quote of the day:
“In the realm of healing, the smallest gesture can have the greatest impact. Never underestimate the power of a kind word or a sincere smile.”