Question
A 72-year-old woman experienced three 10- to 15-minute episodes of “blurred vision” in the right eye over the past week. Her eye examination is normal. The presence of which one of the following signs should elicit the most prompt attention to prevent permanent visual loss?
| A. |
Right carotid bruit
|
| B. |
Scalp tenderness
|
| C. |
Blood pressure of 170/95
|
| D. |
A cardiac murmur
|
Show Answer
|
Correct Answer � B
Explanation
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|
Answer: B. Scalp Tenderness
Explanation:
Temporal arteritis must be considered in anyone with transient visual loss who is over 55 years
of age. The presence of scalp tenderness should raise suspicions further. Permanent visual loss
caused by ischemic optic neuropathy could occur at any moment, and prompt treatment with
corticosteroids could be preventative. A carotid bruit or cardiac murmur may signify a potential
embolic focus and should be evaluated. However, permanent visual loss would be much less
likely. Similarly, hypertension is a risk factor for vascular disease and should be treated, but it
need not be done urgently.
