A 95-year-old woman is brought in by her family for poor vision. She only provides yes or no answers to questions and seems to have a blunted affect. Her family members report that she has been complaining about her vision being poor for years and that the three other ophthalmologists she saw previously had told them she was just getting older. She had undergone uncomplicated cataract extraction with intraocular lens placement bilaterally ten years prior. Her previous visual acuity had been 20/25 OU with correction. Over the last few years, however, she had moderate geographic atrophy of the retinal pigment epithelium centrally and her vision was now 20/70 OU, but her glasses had not been changed in years. She complained that she was no longer able to read and do her crossword puzzles. The family reported that she seemed more withdrawn recently and was not eating very well. They were concerned that perhaps it was because she could not see her food. She was on no medications and lived in a retirement home.
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