A 72-year-old patient comes to the clinic complaining of sudden onset eye pain, nausea, and seeing halos around lights. The nurse notes that the patient’s pupil is mid-dilated and non-reactive to light. What is the most likely cause of these symptoms?
Optic neuritis
Macular degeneration
Narrow angle glaucoma
Cataract
The Correct Answer is C
Choice A: Optic Neuritis
Optic neuritis is an inflammation of the optic nerve that can cause pain and vision loss. The pain typically worsens with eye movement, and vision loss usually occurs in one eye. Symptoms include temporary vision loss, visual field loss, loss of color vision, and flashing lights. However, optic neuritis does not typically cause nausea or seeing halos around lights, and the pupil reaction to light is usually preserved.
Choice B: Macular Degeneration
Macular degeneration primarily affects central vision and is more common in older adults. It can cause blurred or reduced central vision, difficulty recognizing faces, and visual distortions such as straight lines appearing bent. However, it does not cause sudden onset eye pain, nausea, or seeing halos around lights. The pupil reaction to light remains normal in macular degeneration.
Choice C: Narrow Angle Glaucoma
Narrow angle glaucoma, also known as acute angle-closure glaucoma, is a medical emergency characterized by a sudden increase in intraocular pressure. Symptoms include severe eye pain, nausea, vomiting, seeing halos around lights, and a mid-dilated, non-reactive pupil. This condition occurs when the drainage angle between the iris and cornea becomes blocked, leading to a rapid rise in eye pressure. Immediate treatment is necessary to prevent permanent vision loss.
Choice D: Cataract
Cataracts cause clouding of the lens, leading to symptoms such as blurred vision, difficulty seeing at night, sensitivity to light, and seeing halos around lights. However, cataracts develop gradually and do not cause sudden onset eye pain or nausea. The pupil reaction to light is also typically normal in cataract patients.
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Related Questions
Correct Answer is C
Explanation
Choice A Reason:
The client’s tongue is not relevant for diagnosing cataracts. Cataracts are an eye condition characterized by clouding of the lens, which affects vision. The tongue does not provide any information related to the presence of cataracts.
Choice B Reason:
The client’s eyelid is also not relevant for diagnosing cataracts. While the eyelid can be examined for other eye-related conditions, it does not provide information about the lens’s clarity or the presence of cataracts. Cataracts specifically affect the lens inside the eye.
Choice C Reason:
The lens of the client’s eye is the correct area to examine for diagnosing cataracts. Cataracts cause the lens to become cloudy, leading to symptoms such as blurred vision, difficulty seeing at night, and sensitivity to light. An eye examination, including a slit-lamp exam, allows the healthcare provider to see the lens and identify any cloudiness or opacities indicative of cataracts.
Choice D Reason:
The posterior pharynx of the client’s throat is not relevant for diagnosing cataracts. This area is examined for conditions related to the throat and respiratory system, not for eye conditions. Cataracts are diagnosed through an eye examination focusing on the lens.
Correct Answer is D
Explanation
Choice A Reason:
Prescription glasses can help improve vision in the early stages of cataracts by compensating for changes in the lens. However, they do not treat the underlying condition. As cataracts progress, glasses become less effective, and surgery becomes necessary to restore clear vision.
Choice B Reason:
Laser therapy is not used to dissolve cataracts. Instead, it is sometimes used after cataract surgery to treat a condition called posterior capsule opacification, which can occur months or years after the initial surgery. This procedure, known as YAG laser capsulotomy, helps to clear the vision but does not address the primary cataract.
Choice C Reason:
Anti-inflammatory eye drops can be used to manage inflammation and discomfort associated with cataracts or cataract surgery. However, they do not treat or remove the cataract itself. These drops are often part of the post-operative care following cataract surgery.
Choice D Reason:
Cataract surgery is the most effective treatment for cataracts. During the procedure, the clouded natural lens is removed and replaced with a clear artificial lens called an intraocular lens (IOL). This surgery significantly improves vision and is considered the definitive treatment for cataracts.
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