Eye path q

[MudPhud20XX]

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An 81-year-old woman has had difficulty seeing with her left eye for the past 3 years, as shown in the image. On physical examination she has an opacification of the crystalline lens on the left. The degree of opacification makes funduscopy impossible. The cornea and conjunctiva of the left eye are unremarkable. She has 20/100 visual acuity in the remaining eye, with myopia, and funduscopy on the right is normal. Which of the following is the most likely diagnosis?

so based on the vignette, it's probably a cataract. my questions is if the vignette was not given, would you also say this could be age-related macular degeneration where you also start losing the vision centrally...

 

[SBR249]

No, I would not go for ARMD because the macula is also responsible for high acuity vision. The fact that the rest of the picture is not blurred and the contrast is still very good would suggest that the macula is still in good health.