‘Dry’, age-related macular degeneration
Gradual retinal detachment
Serious disorders not to be missed
Drug toxicity (e.g. quinine, methanol, arsenic)
Past history including risk factors for cardiovascular disease, family history, drug history and associated symptoms or problems.
Visual acuity, ophthalmoscopic examination, tonometry, although early ophthalmological referral is recommended
Keep the big three causes in mind—cataract, chronic glaucoma and age-related macular degeneration—and refer for shared care.
In the older patient whose cataract is not significantly improved with the pinhole test consider macular degeneration.