28-year-old patient
Last eye test was 3 years ago
Doesn’t wear any glasses
Has recently noticed difficulty reading newspaper and her mobile phone
She is also sometimes light sensitive
This all started after an episode of fever 1 month ago
Look at the record and answer questions from your assessor.
Record card:
General health: all ok
Ocular history: all ok
Family history: all ok
Vision: RE 6/7.5 LE 6/7.5
Near N8 N8
Refraction: +0.50 +0.50
Add: +1.00 +1.00
N5 N6
Pupils: LE sluggish reaction to light. LE > RE. slow reaction to accommodation
Questions I was asked:
Summarise the history and symptoms
Summarise the signs
What’s your diagnosis?
How would you manage this patient?
Answers:
Summary of history:
- Px has come in complaining of difficulty reading the newspaper and her
mobile phone, unaided
- She also reports feeling photophobic sometimes
- Symptoms all started 1 month after an episode of fever
Summary of signs:
- Px has a small distance rx
- She has reduced near vision
- A +1.00 add improves her near vision from N8 to N5
- Pupil exam shows her LE responds sluggishly to light, her LE pupil is larger
and also has a poor response to accommodation
Last eye test was 3 years ago
Doesn’t wear any glasses
Has recently noticed difficulty reading newspaper and her mobile phone
She is also sometimes light sensitive
This all started after an episode of fever 1 month ago
Look at the record and answer questions from your assessor.
Record card:
General health: all ok
Ocular history: all ok
Family history: all ok
Vision: RE 6/7.5 LE 6/7.5
Near N8 N8
Refraction: +0.50 +0.50
Add: +1.00 +1.00
N5 N6
Pupils: LE sluggish reaction to light. LE > RE. slow reaction to accommodation
Questions I was asked:
Summarise the history and symptoms
Summarise the signs
What’s your diagnosis?
How would you manage this patient?
Answers:
Summary of history:
- Px has come in complaining of difficulty reading the newspaper and her
mobile phone, unaided
- She also reports feeling photophobic sometimes
- Symptoms all started 1 month after an episode of fever
Summary of signs:
- Px has a small distance rx
- She has reduced near vision
- A +1.00 add improves her near vision from N8 to N5
- Pupil exam shows her LE responds sluggishly to light, her LE pupil is larger
and also has a poor response to accommodation
