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This patient is a 3-year-old female who demonstrates significantly decreased vision in both eyes. The most striking feature of her examination is seen in the retina. In both eyes there is temporal traction of the retinal vessels beginning at the disc (see the figure above). The condition is present in both eyes. The media are clear and the intraocular pressure is normal. The eyes are aligned, but nystagmus is present. The mother stated she had an “infection” during the first month of the pregnancy. This is the woman’s first child.

1.	The first question that you should ask the mother is:
	a. Is there a family history of early onset or congenital low vision? b. Does the child complain of pain? c. Has excessive tearing been noted? d. Do the child’s pupils dilate poorly? e. What was the birth weight?
2.	The differential diagnosis in this case would include which of the following:
	a. Eales’ disease b. morning glory disc c. familial exudative vitreoretinopathy d. Coats disease e. all of the above
3.	Management of this condition includes:
	a. immediate vitrectomy b. prophylactic sclera buckling c. lensectomy d. cryotherapy or vitreoretinal surgery in advanced cases e. none of the above

For answers to the above, click here on or after May 17, 2011.