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A tottering, eighty-one year-old gentleman with some evidence of senility is brought to your clinic by his wife.  He is somewhat agitated, claiming that he has suddenly lost vision in his right eye.  You are unable to record an accurate Snellen visual acuity secondary to the man’s aforementioned mental state.

1.	After performing a dilated exam, you suspect longstanding, NOT acute, venous occlusive disease.  (The gentleman has NO history of diabetes.)  Why, as a budding retinal specialist, are you so convinced of the chronicity of this gentleman’s condition?
	a. optic disc pallor b. extensive nature of superficial and deep retinal hemorrhage c. pronounced macular edema d.  evidence of neovascular changes at the optic disc e. “copper-wiring” of vessels
2.	A budding retinal specialist you might be, but, after sharing the patient with your senior partner to confirm your diagnosis, he reprimands you for omitting one imperative step from the exam.  What is that?
	a. scleral depression to evaluate the far periphery for tears b. optokinetic drum testing to ascertain some basic visual threshold c. undilated gonioscopy to evaluate angle for neovascularization d.  ocular coherence tomography (OCT) e. Goldmann visual field testing
3.	In an eighty-one year-old gentleman, you feel it safe to assume that the nature of his vein occlusion is vasculopathic.  What simple office test (even in an ophthalmologist’s office) might be worth performing before referring him to his general practitioner?
	a. blood pressure b. EKG c. gait/mobility testing d.  Mini-Mental Status Exam e. rectal exam
4.	With evidence of neovascularization, what preventative measure would be warranted?
	a. cryotherapy b. pan-retinal photocoagulation c. vitrectomy d.  none, just careful follow-up e. systemic hemodilution
5.	In a truly new-onset central retinal vein occlusion, what causes the majority of visual loss?
	a. vitreous hemorrhage b. optic disc swelling c. macular edema d.  IOP spike e. choroidal ischemia
6.	Assuming a 40 year-old male presented with a new-onset central retinal vein occlusion, how would your management/work-up differ, if at all?
	a. It would not differ -- all CRVOs are to be treated equally. b. Immediate pan-retinal photocoagulation-- you want to safeguard vision in younger patients and always treat more aggressively. c. You can bypass gonioscopy, as younger patients rarely develop neovascularization. d.  Inquire about a family/personal history of blood disorders, consider ordering some basic labs (ESR, homocysteine) and refer to a hematologist for further work-up. e. Tactfully inform him that he should consider obtaining a seeing-eye dog, as his fellow eye will almost certainly lose vision within a few years.