A 68-year-old male with long-standing poorly controlled hypertension presents with painless progressive bilateral visual blurring and difficulty driving at night. Ophthalmoscopy reveals bilateral crystalline lens clouding and opacification with loss of the red reflex. What is the diagnosis?

Answer and explanation

Correct answer: D. Senile Cataract

  1. Step 1: A cataract is the progressive clouding, yellowing, or opacification of the crystalline lens of the eye.
  2. Step 2: Senile cataracts are the leading cause of reversible blindness worldwide, characterized by decreased visual acuity, glare, and loss of the fundoscopic red reflex.
Answer
Senile Cataract.
Why not the others: 'Primary open-angle glaucoma' causes progressive, painless peripheral visual field loss with increased optic nerve cup-to-disc ratio; 'Age-related macular degeneration' causes central scotoma and distortion (metamorphopsia); 'Retinal detachment' presents acutely with sudden photopsia (flashes of light), showers of floaters, and a 'curtain coming down' over vision.

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