A man aged 89+ sent to Eye Emergency Department by optician | Figure 1

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Patient Details

Age: 89+
Presenting Complaints: Reduction in vision in right eye for 3 days.

Visual Acuity:

Right eye: Previously 6/12. Currently counting fingers.
Left eye: Perception of light but history of amblyopia (no change).

Visual Fields:

Right eye: Inferior quadrants affected.
Left eye: No abnormality.

Retinal Imaging Results:

Showed a superior branch retinal artery occlusion.

Associated History:

Mild headache noted for around 3 days - mainly on the right side.
Has been eating less due to pain and lack of appetite.
Both shoulders feel quite stiff (worse on left) - new symptom.
History of osteoarthritis in both knees.
No nausea or photophobia.
Has lost about a stone in the last few months. No fevers.

Past Medical History:

Hypertension
Type 2 diabetes - on insulin
Osteoarthritis in both knees
Amblyopia in left eye

Social History:

Lives alone in a bungalow, mobile with 2 sticks, manages daily activities independently.
Neighbours assist around the house and with shopping.

Discussion Questions:

What is your top diagnosis?
What investigations would you do?
What is your plan for treatment?