A 65-year-old man with emphysema and bronchitis has come to the clinic for a follow-up appointment.
On assessment the nurse might expect to see which finding?

Choice A rationale

Separation of the retina from the choroid, also known as retinal detachment, is a different condition altogether. Retinal detachment can cause vision loss but is not related to macular degeneration. This condition often requires immediate medical attention to prevent permanent vision loss and is typically characterized by the sudden appearance of floaters, flashes of light, and a shadow or curtain over a portion of the visual field.

Choice B rationale

Peripheral vision loss and seeing halos around light are more commonly associated with conditions like glaucoma. Glaucoma involves increased intraocular pressure, which can damage the optic nerve and lead to peripheral vision loss and seeing halos around lights. This condition can be managed with medications or surgery to lower intraocular pressure and prevent further vision loss.

Choice C rationale

Complaints of severe pain and pressure in the eye are indicative of acute angle-closure glaucoma. This is a medical emergency and requires prompt treatment to reduce intraocular pressure and prevent optic nerve damage. The symptoms of acute angle-closure glaucoma are sudden and severe and can include headache, nausea, and vomiting, along with the eye pain and pressure.

Choice D rationale

Central vision loss with intact peripheral vision is characteristic of macular degeneration, particularly age-related macular degeneration (AMD). AMD affects the macula, the part of the retina responsible for sharp, central vision. As the macula deteriorates, central vision becomes blurry or wavy, making it difficult to read, drive, or recognize faces, while peripheral vision remains largely unaffected.

Choice A rationale

Myopia, or nearsightedness, is when distant objects appear blurry because light rays focus in front of the retina. A Snellen exam result of 20/50 means the client can see at 20 feet what someone with normal vision sees at 50 feet, indicating reduced distance vision. However, this condition does not correlate with the ability to read the Rosenbaum chart, which is for near vision, thus excluding myopia.

Choice B rationale

Normal vision is not indicated by a Snellen exam result of 20/50, as this signifies a visual impairment where the client sees at 20 feet what a person with normal vision sees at 50 feet. Normal vision would be indicated by 20/20 on the Snellen exam.

Choice C rationale

Presbyopia is the age-related loss of the eye's ability to focus on near objects, typically noticeable in people over 40. Although this condition involves difficulty reading at close range, the client's uncorrected Snellen exam result of 20/50 pertains to distance vision, which differentiates presbyopia from the given scenario.

Choice D rationale

Hyperopia, or farsightedness, is when close objects appear blurry because light rays focus behind the retina. The client's ability to read the Rosenbaum chart without difficulty indicates good near vision, while the Snellen exam result of 20/50 reflects reduced distance vision, thus supporting the diagnosis of hyperopia.