Item: 1 of 1 ~ 1 • Mark -<] C> Jill ~· ~J

QID: 24098 .1 Previous Next Lab'V!I!ues Notes Calculator

• 1
A 71-year-old man presents to his primary ca re physician with a complaint of vision changes. He states that over the past ~~AI
several months he has noticed that his vision has been getting worse, and it is getting more difficult to do activities such
as driving and r eading .

What is the most common cause of bilateral vision loss in the United States?

A. Chemical burns
B. Macular degeneration

C. Retinal artery occlusive disease

D. Tempora l arteritis

E. Trauma

Lock
s
Suspend
0
End Block
Item: 1 of 1 ~ 1 • Mark -<] C> Jill ~· ~J
QID: 24098 .1 Previous Next Lab'V!I!ues Notes Calculator

1
The correct answer is B. 880/o chose this.
Macu lar degeneration (M D) is a disorder affecting the centra l portion of the retina . MD presents as gradua l centra l vision loss
in one or both eyes, and patients often com plain of difficulty performing tasks such as reading or driving . MD is classified as
dry or wet. Dry MD is caused by deposits of extracellu lar material (d rusen ) in the macula and/or atrophy of the retinal
pigment epithelium . Wet MD typically presents as a more rapid loss of vision (weeks to months) and is caused by growth of
abnormal blood vessels in the subretinal space . Age-relat ed macular degeneration is the leading cause of adult bl indness in
industria lized countries . Other less common but important causes of blindness include cataracts, diabetic retinopathy,
glaucoma, and trauma. I n addition to age, risk factors for MD include a family history, smoking, and coronary artery disease.
Glaucoma Retina Diabetic retinopathy Retinal pigment epithelium Coronary artery disease Macular degeneration Macula of retina Retinopathy Cataract Pigment Epithelium

Visual impairment Atrophy Diabetes mellitus Drusen Blood vessel Retinal

A is not correct. 1% chose this.

Despite being one of the true emergencies of the eye and being responsible for blindness in many cases, this diagnosis is not
considered as the most common cause of blindness in the United States . Chemical burns can be due to acid or alkal i; alkali
burns tend to be more serious. Treatment for chemical bu rns entails vigorous irrigation and usually an emergent
ophtha lmology consu lt.
Ophthalmology Alkali Visual impairment Irrigation Chemical bum United States

C is not correct. 70/o chose this.

Central retina l artery occlusion often presents as a sudden painless loss of unilateral vision. I t can occur in patients with
hypertension, atherosclerosis, or hypercoagulable states.
Central retinal artery ocdusion Atherosderosis Ocular ischemic syndrome Hypertension Central retinal artery Vascular ocdusion Retinal Thrombophilia

D is not correct. 2% chose this.

Temporal arteritis or giant cell arterit is is a vasculitis affecting large- and medium-sized vessels. Patients can present w ith
many systemic compla ints, including fever and fatigue, but may also have headache, jaw claudication, and sca lp tenderness .
Although rare, if left untreated, temporal arteritis can lead to permanent vision loss in one or both eyes.
Giant-cell arteritis Claudication Vasculitis Giant cell Headache Fatigue (medical) Visual impairment Scalp Arteritis Fever

Lock
s
Suspend
0
End Block
Item: 1 of 1 ~ 1 • Mark -<] C> Jill ~· ~J
QID: 24098 .1 Previous Next Lab'V!I!ues Notes Calculator

1 burns tend to be more serious. Tr eatment for chemical burns entails vigorous irri gation and usually an emergent
ophtha lmology consu lt.
Ophthalmology Alkali Visual impairment Irrigation Chemical bum United States

C is not correct. 7% chose this.

Central retina l artery occlusion often presents as a sudden painless loss of unilateral vision. It can occur in patients with
hypertension, atherosclerosis, or hypercoagulable states.
Central retinal artery occlusion Atherosclerosis Ocular ischemic syndrome Hypertension Central retinal artery Vascular occlusion Retinal Thrombophilia

D is not correct. 20/o chose this.

Temporal arteritis or giant cell arterit is is a vasculit is affeding large- and medium-sized vessels. Patients can present w ith
many systemic compla ints, including fever and fatigue, but may also have headache, jaw claudication, and sca lp tenderness .
Although rare, if left untreated, temporal arterit is can lead to permanent vision loss in one or both eyes.
Giant-cell arteritis Claudication Vasculitis Giant cell Headache Fatigue (medical) Visual impairment Scalp Arteritis Fever

E is not correct. 20/o chose this.

Although veterans of the I raq war are increasingly r eturning to the Un ited States with shrapnel-induced blindness, traumatic
injury is not the most common cause of bilateral vision loss.
Iraq Iraq War Visual impairment United States Major trauma

Bottom line:
Macu lar degeneration is the most common cause of bilateral vision loss in the Un ited States.
Macular degeneration Visual impairment United States

References:
FA Step 2 CK 9th ed p 294
FA Step 2 CK 8th ed p 277

Lock
s
Suspend
0
End Block