Hi, i have a presentation to do on the following case scenario.. I was wondering if anyone could give me a few pointers etc.. (I'm a student.. )
Thanks
Case Scenario:
You examine Mr Simpson (age 67) who was diagnosed with ARMD 2 years ago. Initially, he was told that he suffered a macular hemorrhage in his right eye but vision in his left eye was stable. Three days ago he noticed some deterioration in his left eye. Mr Simpson is a retired teacher who always enjoyed reading, doing crosswords and playing the piano. He used to make model ships and would like to resume this hobby. He also like walking his dog and going out with the local running club. Due to his poor vision he had to give up driving a few years ago but he still goes out on his bicycle.
The inital clinical findings are:
Current Rx: Bifocal D22
Re: +2.50/+1.00x90 3/60 Le: +2.00/+0.50x90 6/24
Binoc: 6/18 Add: +3.00 Re: N40 LE: N10 slow
Refraction: Re: +3.00/+1.00x90 3/60 Le: +2.00/+1.00x90 6/24
Near Addition:
with add +3.00 (binoc) N10 slow at 33cm, readings seems more fluent when the right eye is occluded; with +6.00 binoc N6 can be read at 17cm; with the right eye occluded and additional lighting (anglepoise lamp) N5 is possible.
Tonometry (Pulsair NCT @ 3pm) Re: mean 14mmHg Le: mean 12mmHg
Clinical Management:
- discuss your clinical management plan for this patient, including additional tests that would need to be carried out.
- describe each of these techniques, how they are carried out and any instructions that you would give to your patients, in a language appropriate for lay patients.
- discuss the clinical condition that you suspect and describe possible treatment options, their advantages and limitation. what other visual difficulties, not describe here, may this patient have?
Optical Management:
- Recomment appropriate visual aids. using appropriate language, explain how you would advise this patient regarding the optical management of his visual problems. you can advise as many visual aids as necessary but you need to address all his visual problems.
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