Ted Jones is a 31 year old man presenting to eye casualty with a unilateral red, photophobic eye with blurred vision.
Ted is a fit and healthy builder who works on site driving a van. He is in good health and taking no medications. He lives with his wife and 18 month old child. He smokes ten cigarettes per day and drinks two pints of beer on a Friday and Saturday night.
In A&E he has a red left eye with no discharge. Background light is uncomfortable and the eye is painful all the time. He does not wear glasses. He has no other complaints other than his back hurts a bit but he has put this down to extra weekend work on the building site.
- Vision is 6/12 in the left eye compared to 6/5 in the right. ( no improvement with pin hole.
- The pupil in the left eye is an unusual shape.
- There are white dots on the back of the inferior 1/3 of the cornea.
- The view to the optic disc is clear and the optic disc is normal.
Question 1: What tests would you request in A&E to assist with diagnosis?
Question setter & Expert: Ms Sarah Maling, Consultant Ophthalmologist & Clinical Teaching Fellow UCLMS
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