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Discussion Starter · #1 ·
A 56-year-old woman with a well controlled diabetes mellitus type 2 complains of decreased vision. She reports decreased ability to visually differentiate between objects with both her eyes. This is worse at night and she describes “rings around lights” at night. She does not experience pain and there is no diplopia (‘double vision”).
Which one of the following is the most likely diagnosis?
A. Cataracts
B. Closed-angle glaucoma
C. Temporal arteritis
D. Diabetic retinopathy
E. Macular degeneration
 

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Rainbow rings around lights is typical presentation of angle-closure glaucoma! Lack of pain doesn't suggest the diagnosis though.

Still I would go with B.
 

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I will say glaucoma - cataracts due to variation in glucose levels can be expected but the stem says tht she is a "well controlled" case. and its a little premature for cataracts - senile ones.

I am not sure, but rings around lights at night seem to point towards glaucoma - lack of pain is again a contradicting point...
:notsure::notsure::notsure:
 

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Could it be non-acute angle closure glaucoma because pain is lacking?
 

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Discussion Starter · #10 ·
glaukoma seems a closer answer. because it is well controlled DM. sorry guys i dont have the answer. :confused:
 

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Halos are seen in corneal edema only eg in glaucoma.
only 10% of closed angle glaucoma present with acute crisis which require surgery.in clinical practice it may present as painless also.
 

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The answer of this Q (in most of the answers between cataracts & glaucoma.
The absence of pain, halos at night, age, decreased night vision & DM (the fact that DM is well controlled doesn't mean no complications) point to cataracts.
Rings around lights at night points towards glaucoma. It is true Visual halos in glaucoma (seen halos around objects or lights)
Other important symptoms of closed angle glaucoma are not present :
Severe eye pain
Severe headache
Tender eyeball
Hard eyeball
Red eye
Swollen eye
Nausea

Remember:
Causes of Visual halos:

  • Short-sighted
  • Diabetes
  • Diabetic lens osmosis
  • Glaucoma
  • Cataract
For that I go with Cataracts.
 

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Discussion Starter · #15 ·
cataract

wow this is what a few more months of reading does to u. i looked at the question n tried a second guess n now i believe it is cataract. i still dun have the answer, but im pretty sure its cataract now from seeing a ring around light especially. Happy-2
 

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Cataract

particularly in high-risk groups such as diabetics, it may be advisable to seek medical opinion if a "halo" is observed around street lights at night, especially if this phenomenon appears to be confined to one eye only.
 
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