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A 65-year-old man, with a history of transient ischemic attack, presents to the emergency department complaining of sudden loss of vision in his right eye. Physical exam reveals a dilated and sluggish right pupil. On fundoscopy the right retina is pale, the fovea is dark red (Figure A). What is the proper treatment for this patient?
IV acetazolamide, pilocarpine, laser iridotomy
Laser or cryotherapy to reattach the retina
IV acetazolamide, ocular massage, carbogen therapy
Observation, elevate head of the bed at nighttime
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A 67-year-old woman presents to the emergency department complaining of right eye blindness. She states she first noticed the vision loss when she woke up this morning. She denies any pain or other associated symptoms. Review of systems is notable for passive suicidal ideation as the patient's husband died in the ICU last night. Her temperature is 98.3°F (36.8°C), blood pressure is 174/104 mmHg, pulse is 80/min, respirations are 12/min, and oxygen saturation is 98% on room air. Physical exam is notable for the patient being unable to see out of her right eye with normal vision in her left eye. Her cranial nerves are otherwise intact and she has normal strength and sensation in her upper and lower extremities. A fundoscopic examination is performed and the results are demonstrated in Figure A. Which of the following is the most likely etiology of this patient's symptoms?
Detachment of the retina
Increased intraocular pressure
Ischemia of the brain
A 74-year-old man with a history of type II diabetes and a 40 pack-year smoking history presents to the emergency room complaining of sudden-onset, painless vision loss in his left eye. He describes the feeling as if things went black in his left eye suddenly. His temperature is 98.0°F (36.7°C), blood pressure is 154/94 mmHg, pulse is 100/min, respirations are 17/min, and oxygen saturation is 98% on room air. Neurological exam reveals cranial nerves III-XII as intact. The patient is unable to see out of his left eye but has normal vision in his right eye. The rest of his exam including strength, sensation, and gait are unremarkable. An ECG is performed as seen in Figure A and an ultrasound of the eye is performed as seen in Figure B. Fundoscopy is performed as seen in Figure C. A CT scan of the head is currently pending. Which of the following is the most likely diagnosis?
Central retinal artery occulsion
Central retinal vein occlusion