A 68-year-old woman is in the eye clinic for a checkup. She tells ...

[Metfan725]

A 68-year-old woman is in the eye clinic for a checkup. She tells the nurse that she has been having trouble reading the paper, sewing, and even seeing the faces of her grandchildren. On examination, the nurse notes that
 
  she has some loss of central vision but her peripheral vision is normal. These findings suggest that she may have:
  a.
  Macular degeneration.
  b.
  Vision that is normal for someone her age.
  c.
  The beginning stages of cataract formation.
  d.
  Increased intraocular pressure or glaucoma.

Question 2

The nurse notices the presence of periorbital edema when performing an eye assessment on a 70-year-old patient. The nurse should:
 
  a. Check for the presence of exophthalmos.
  b. Suspect that the patient has hyperthyroidism.
  c. Ask the patient if he or she has a history of heart failure.
  d. Assess for blepharitis, which is often associated with periorbital edema.

[Li Jun]

Answer to Question 1

ANS: A
Macular degeneration is the most common cause of blindness. It is characterized by the loss of central vision. Cataracts would show lens opacity. Chronic open-angle glaucoma, the most common type of glaucoma, involves a gradual loss of peripheral vision. These findings are not consistent with vision that is considered normal at any age.

Answer to Question 2

ANS: C
Periorbital edema occurs with local infections, crying, and systemic conditions such as heart failure, renal failure, allergy, and hypothyroidism. Periorbital edema is not associated with blepharitis.

[Metfan725]

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