A 64-Year-Old Man Comes to the Office for a Preventive

A 64-year-old man comes to the office for a preventive visit.  The patient has type 2 diabetes mellitus, which is being managed with lifestyle modification.  He has had no polyuria, polydipsia, or changes in weight but states that he has had trouble seeing distant objects for the past several months.  He has never had vision problems before and reports normal near vision.  Two weeks ago the patient saw an optometrist who prescribed glasses with −2.5 diopter lens on the right and −0.75 diopter lens on the left that have improved his vision.  Dilated eye examination 6 months ago was unremarkable.  His glycated hemoglobin level is 6.8%.
Which of the following is the most likely cause of this patient's visual symptoms?

A) Diabetic retinopathy
B) Macular degeneration
C) Nuclear cataract
D) Open-angle glaucoma
E) Presbyopia

Correct Answer:

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