Case Studies in Ophthalmology
Cases for the Ophthalmology Clerkship
Note to Medical Students on the Ophthalmology Rotation at the University of Iowa:
Print the question and answer sheet (Ctrl-Print or Command-Print) and enter your answers on it. You may prefer to type your answers on this page and then print it. If you do this, be careful that your full answer shows in the printout. Experience with Internet Explorer has been less than optimal.
Return the printed copy with your answers to Michelle Snyder or Dr. Kemp via campus mail (11290 PFP) or scan as a pdf and email to Michelle at michelle-r-snyder@uiowa.edu or Dr. Kemp at pavlina-kemp@uiowa.edu.
Case #13 Central Retinal Artery Occlusion
History
A 56-year-old woman, 3 days before she was seen in the Ocular Vascular Clinic, discovered painless loss of vision in the left eye on waking up in the morning.
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Question #1
When evaluating the patient's history, what would you ask the patient?
Question #2
What would be your differential diagnosis and what ophthalmic diagnostic tests would you order?
Question #3
Would you order any systemic evaluation, and if so, what?
Question #4
What are the long-term prognosis and complications of this condition?
Question #5
What treatment options would you consider for this or any other patient with this condition?
Question #6
How long can retina survive without perfusion of its arterial blood supply?
References
Duke-Elder S: Diseases of the retina. In System of Ophthalmology Vol X, St. Louis, Mosby, 1967, pp.58-97.
Hayreh SS, Kolder HE, Weingeist TA: Central retinal artery occlusion and retinal tolerance time. Ophthalmology 1980;87:75-78.
Hayreh SS, Podhajsky P: Ocular neovascularizaton with retinal vascular occlusion - II. Occurrence in central and branch retinal artery occlusion. Arch Ophthalmol 1982;100:1585-1596.