Cataract: The Daily PANCE Blueprint
A 65-year-old man presents to your clinic complaining of gradually worsening vision in both eyes over the past year. He reports difficulty driving at night and experiencing glare from headlights. On examination, you note clouding of the lens in both eyes. Visual acuity is 20/40 in both eyes. What is the most appropriate next step in management?
A. Immediate surgical referral
B. Prescribe anti-glaucoma eye drops
C. Initiate corticosteroid eye drops
D. Prescribe new corrective lenses
E. Lifestyle modification and observation
Answer and topic summary
The answer is E. Lifestyle modification and observation
The patient’s symptoms and examination findings are consistent with cataracts. In the early stages, lifestyle modifications like using brighter lighting and anti-glare sunglasses can be effective. Surgery is generally reserved for more severe cases where vision impairment significantly affects daily activities.
Incorrect Answers:
- A. Immediate surgical referral: Surgery is generally indicated when the cataract significantly impairs vision and affects the patient’s quality of life. This patient’s visual acuity is still 20/40, and immediate surgery is not warranted.
- B. Prescribe anti-glaucoma eye drops: There is no evidence of glaucoma in this case.
- C. Initiate corticosteroid eye drops: Corticosteroids are not used for the treatment of cataracts and can actually exacerbate them.
- D. Prescribe new corrective lenses: While new lenses may temporarily improve vision, they do not address the underlying issue of lens clouding.
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