National Registry of Certified Medical Examiners (NRCME) DOT Practice Exam

What type of vision impairment straddles both central and peripheral loss?

1. Macular degeneration

2. Cataracts

3. Diabetic retinopathy

4. Retinal detachment

The correct answer is: Diabetic retinopathy

The type of vision impairment that straddles both central and peripheral loss is diabetic retinopathy. This condition occurs as a complication of diabetes and affects the blood vessels in the retina, leading to changes that can impair both central vision—which is crucial for tasks like reading and driving—and peripheral vision. As the disease progresses, it can result in swelling and bleeding in the retina, leading to widespread vision loss that impacts multiple visual fields. Macular degeneration primarily affects the central vision, primarily due to damage to the macula, making it less relevant to mixed vision loss. Cataracts usually cause a clouding effect over the entire lens, leading to blurriness but do not inherently affect central versus peripheral vision specifically. Retinal detachment can severely impact vision, but it generally causes sudden and severe loss of a specific area of vision rather than a gradual impairment that affects both central and peripheral vision.