Vsolution Eye Care

Here’s a fundus photograph that deserves a second—and maybe third—look. 🔍👀

Take a close look at the optic disc, retinal vessels, and surrounding retina.

🧠 CLINICAL CHALLENGE:
What possible pathology or abnormalities can you identify in this fundus image?

And don’t stop at just one finding…

👉 What are the key features that led you to your diagnosis?
👉 What differential diagnoses would you consider?
👉 What additional examination or investigation would you request to confirm your suspicion?

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A 52-year-old patient presents with a recent onset of blurred vision and intermittent headache. There is no history of ocular trauma.

VA:
OD: 6/9
OS: 6/6

IOP: 15 mmHg OU

Anterior segment examination is unremarkable.

But on fundus examination, the optic nerve head appears elevated and hyperemic, with indistinct disc margins.

👁️ Take a close look at the fundus photograph.

Questions for you:

1️⃣ What is your most likely diagnosis?
2️⃣ Is this true optic disc edema or pseudopapilledema?
3️⃣ If you think it's optic disc edema, what are your top differential diagnoses?
4️⃣ What investigations would you request next?
5️⃣ What finding would make you particularly concerned about raised intracranial pressure?

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Have you ever noticed spoke-like, wedge-shaped opacities extending from the edge of the lens toward the center? 👀

That classic appearance may point to a cortical cataract.

Cortical cataract is an age-related cataract in which the lens cortex becomes cloudy, often producing characteristic radial or spoke-like opacities.

🔎 Common symptoms include: • Blurred or hazy vision
• Glare and halos, especially around headlights at night
• Reduced contrast sensitivity
• Difficulty seeing in bright conditions
• Monocular diplopia/polyopia in some patients
• Progressive difficulty with daily visual tasks as the opacity advances

💡 Clinical pearl:
Because cortical opacities can initially develop in the peripheral lens, visual acuity may remain relatively good in the early stages. Symptoms can, however, become troublesome before the opacity significantly involves the visual axis.

👁️ What would you look for on examination?
Slit-lamp examination can reveal the characteristic radial, spoke-like cortical lens opacities.

⚠️ Cataracts are treatable, but don't assume every gradual reduction in vision is simply “old age.” A comprehensive eye examination is important to determine the cause.

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Take a close look at this fundus photograph. There are some interesting vascular abnormalities hiding in plain sight.

🩺 YOUR TASK:

1️⃣ What is your spot diagnosis?
2️⃣ What vascular abnormality can you identify?
3️⃣ Can you spot the aneurysmal changes?
4️⃣ What other findings do you notice on the fundus?
5️⃣ Bonus: What would be your differential diagnoses?

Let’s see who can pick out the subtle findings! 👀

Optometrists, ophthalmologists, ophthalmic nurses, students & eye-care enthusiasts — this one is for you.

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A 24-year-old patient presented to the eye clinic with a 3-day history of a small central dark spot in the vision of one eye.

The patient reported that the symptoms started after staring directly at the sun for several minutes during an outdoor event. There was no history of ocular trauma, pain, redness, or previous ocular surgery.

Visual acuity: mildly reduced in the affected eye
Anterior segment: unremarkable
Fundus examination: a subtle foveal/foveolar reddish-yellow spot was noted at the macula, with surrounding retinal changes.

🔎 Clinical question:
What is your diagnosis from the fundus image?

👉 Solar retinopathy (photic maculopathy) should be high on the list.

But here's the interesting part… 👀

Apart from the foveolar lesion suggestive of solar retinopathy, can you spot ANY OTHER pathology or abnormal retinal finding in this fundus?

Don't just look at the macula—scan the entire fundus carefully. 🧐

Drop your observations in the comments.
Let's see who can identify the second finding before checking the comments! 👇

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Apart from the obvious Valsalva maneuver, take a closer look at this fundus image. 👀

🔎 What other clinical finding(s) can you identify?
🧠 What is your most likely diagnosis?
💊 And most importantly—what would be your treatment/management plan?

Don’t just name the finding. Tell us what you would do next and why. 👇

Become a subscriber today for exclusive clinical cases, advanced eye care insights, members-only discussions, and premium educational content including OCT, A and B scan interpretation and access to online consultation. Your support helps us continue educating and saving sight. Use the link 👉 https://www.facebook.com/Vsolutioneyecare/subscribe/