Question

A 70-year-old male presents with central unilateral metamorphopsia. Which all conditions can affect the fellow normal eye over time? How will you instruct the patient to monitor his vision?

Hint:

Regular monitoring using the Amsler grid and frequent eye exams can help detect early changes in the fellow eye, allowing for early intervention and treatment.

Answer 1

Step 1: Conditions That Can Affect the Fellow Normal Eye Over Time.
In patients with unilateral central metamorphopsia, especially those with underlying conditions like AMD or diabetic retinopathy, the fellow eye may also be at risk for developing similar conditions. Key conditions that can affect the fellow eye include:
(1) Age-Related Macular Degeneration (AM:
- AMD is often bilateral, and even if the other eye is currently unaffected, it may develop AMD over time, particularly if there is a family history or risk factors such as smoking or poor nutrition.
(2) Diabetic Retinopathy:
- Patients with diabetic retinopathy in one eye are at higher risk of developing the condition in the fellow eye, particularly in those with poorly controlled blood sugar.
(3) Retinal Vein Occlusion (RVO):
- The fellow eye may develop retinal vein occlusion, especially in patients with vascular risk factors such as hypertension or diabetes.
Step 2: Instructions for Monitoring Vision.
Patients with unilateral metamorphopsia should be educated on how to monitor their vision for signs of changes in the fellow eye:
(1) Amsler Grid Test:
- Instruct the patient to regularly use the Amsler grid test for both eyes to detect any early changes such as metamorphopsia or central scotoma.
(2) Regular Eye Exams:
- Encourage the patient to schedule regular follow-up visits with an eye care provider, including a dilated fundus examination to detect any early signs of retinal disease in the fellow eye.
(3) Report Changes:
- Advise the patient to report any sudden changes in vision, such as new blurred or distorted vision, promptly.