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Age-related macular degeneration — RACGP Fellowship MCQ

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ModerateENT, OphthalmologyAge-related macular degenerationRACGP Fellowship

A 68‑year‑old woman presents with gradual central vision distortion in one eye. Amsler grid testing is abnormal. She has no eye pain or redness. Visual acuity is reduced compared with last year. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Urgent ophthalmology referral for suspected neovascular age‑related macular degeneration

Explanation lettering: E = shown as A · D = shown as B · B = shown as D · A = shown as E

Option C is correct. An elderly patient with painless central distortion and abnormal Amsler grid testing highly suggests neovascular age‑related macular degeneration (wet AMD), a sight‑threatening condition. Australian general practice guidance advises that such symptoms warrant urgent ophthalmologic assessment. Routine optometry review (A) delays diagnosis; chloramphenicol (B) is for infection and inappropriate here. Prednisolone (D) is indicated in painful optic neuritis, not painless macular pathology. Reassurance (E) is unsafe, as wet AMD can progress rapidly without treatment.

Reference: RACGP AFP “Eye care in the elderly” (2014) and Aust Prescr “Treatment of age‑related macular degeneration” (2012)