Question

A 54-year-old patient in the recovery room for an open-heart surgery, complained of sudden painless loss of vision in his right eye. Visual acuity assessment of the right eye reveals perception of light vision only. The patient cannot count fingers close to face. The ONLY expected anterior segment examination finding in this patient would be:

1) Vitreous hemorrhage
2) Rubeosis iridis
3) Cataract
4) Angle-closure glaucoma

Answer 1

Following open-heart surgery, a patient's complaint of sudden painless loss of vision with perception of light vision only and no anterior segment abnormalities likely indicates a vascular event such as retinal artery occlusion.

Step-by-step explanation:

The sudden painless loss of vision in a patient's right eye following open-heart surgery could be due to an embolic event leading to retinal artery occlusion. In the absence of active inflammation, bleeding, or acute angle-closure, the anterior segment examination is likely to be unremarkable. Anterior segment changes such as vitreous hemorrhage, rubeosis iridis, cataract, and angle-closure glaucoma are typically associated with different clinical presentations and are hence not the expected findings in this case.

An embolus could obstruct the ophthalmic artery or one of its branches, leading to a sudden loss of vision due to the retina's dependency on a steady blood supply. This occurrence is not directly related to visual acuity as assessed by tools like the Snellen chart, which evaluates the eye's capability to see at a distance, but rather to the interruption of blood flow to the eye.