An online image interpretation exercise aimed at revising decision making in macular-related presentations. Module C20500, two general CET points for optometrists and DOs.
Scroll down to look at each image, read the case information and then note down your answers for the related questions. Once you have done all 12, click on the link below to enter your answers online.
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Image A:
- L eye
- 64 yr old
- (R 6/6-1) L 6/9-1
- Aware of some early distortion on viewing straight edges
- Was told had early AMD 2 years ago by optometrist
- No other health concerns
1/ What are the discrete white lesions?
A Circinate exudation
B Drusen
C Focal laser burns
D Artefacts
2/ What is the most appropriate management?
A Image and review in six months
B Advise regarding nutrition, smoking and Uv
C Emergency referral to casualty
D Rapid referral to vitreoretinal clinic within 2/52
Image B:
- 84 yr old, L eye
- Annual review
- (R 6/15) L 6/12
- No reported distortion
- Patient wants help with reading newspapers
- No other concerns
3/ What are the darker patches?
A Subretinal blood
B Pigmentation
C Choroidal scarring
D Longstanding drusen
4/ What is the most appropriate management?
A Refer via GP
B Rapid referral to vitreo-retinal clinic within 2/52
C Advice re lighting, magnification, smoking, nutrition and UV and review in 12/12
D As C but also give Amsler for self monitoring
Image C:
- 69 yr old noticed dramatic drop in R acuity yesterday
- L 6/6 (R 6/60)
- No known relevant ocular or systemic history
5/ Which of the following is the biggest modifiable risk factor for this condition?
A Age
B UV exposure
C Smoking
D High cholesterol
6/ What is the most appropriate management?
A Image and review in 6 months
B Advise regarding nutrition, smoking and Uv
C Emergency referral to casualty
D Rapid referral to vitreoretinal clinic within 2/52
Image D:
- 79 yr old noticed drop in R acuity yesterday
- L 6/9 (R 6/24)
- Previous diagnosis of ‘dry’ AMD at HES three years ago and discharged
7/ From where is the blood originating?
A Choroidal vasculature
B Choriocapilaris
C Venous proliferation from choriocapillaris
D Intraretinal vessels
8/ What is the most appropriate management?
A Image and review in six months
B Advise regarding nutrition, smoking and Uv
C Emergency referral to casualty
D Rapid referral to vitreoretinal clinic within 2/52
Image E:
- 56 yr old myope (R+L -6.50 DS mean sph)
- Sudden loss of vision in the left eye in last 24 hrs
- No previous relevant ocular or systemic illness reported
9/ Which of the following is not a predisposing factor for this presentation?
A Diabetes
B Myopia
C Trauma
D Age
10/ What is the most appropriate management?
A Image and review in six months
B Advise regarding nutrition, smoking and UV
C Emergency referral to casualty
D Rapid referral to vitreoretinal clinic within 2/52
Image F:
- 26 yr old boxer jumper noticed loss of acuity after a bout three days ago
- R 6/5 L 6/15
- No other relevant history
11/ What is the underlying cause of this appearance?
A Congenital vascular weakness
B Increase in VEGF levels
C Sudden pressure wave transferred to retina
D Rapid head movement
12/ What is the most appropriate management?
A Image and review in six months – should reabsorb
B Refer to GP
C Emergency referral to casualty
D Rapid referral to vitreoretinal clinic within 2/52