A 68-year-old client comes to the outpatient clinic and complains to the attending nurse about his increased difficulty with “close-work” such as knitting. He indicates he does not have difficulty seeing objects on either side but does state that straight lines appear distorted or wavy. The nurse suspects which of the following disorders is consistent with the client’s reported symptoms?
A. Glaucoma
B. Cataracts
C. Macular degeneration
D. Subconjunctival hemorrhage
Correct Answer: C. Macular degeneration
Macular degeneration, often age-related macular degeneration (AMD or ARMD), is a medical condition that usually affects older adults and results in a loss of vision in the center of the visual field (the macula) because of damage to the retina. It occurs in “dry” and “wet” forms. It is a major cause of blindness and visual impairment in older adults (>50 years). Macular degeneration can make it difficult or impossible to read or recognize faces, although enough peripheral vision remains to allow other activities of daily life.
Option A: Glaucoma is a condition of increased intraocular pressure in the eye that may progress to a loss of vision. This results in a characteristic optic nerve head appearance on fundoscopic examination and a corresponding progressive loss of vision.
Option B: A cataract is a disease of the eye in which the normally clear lens has opacified which obscures the passage of light. It is a gradually progressive disease and a significant cause of blindness around the world. This blinding disease can affect infants, adults, and older people, but it predominates the latter group. It can be bilateral and vary in severity.
Option D: The red-eye is a common complaint in emergency departments and outpatient clinics. One frequent cause is a subconjunctival hemorrhage. Subconjunctival Hemorrhage (SCH) is a disorder that can occur for the most part from benign situations. However, there are certain times when subconjunctival hemorrhages can occur as a manifestation of a more dangerous underlying diagnosis, especially if persistent or recurrent.
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