Your examination of a patient,who states that she is not able to see as clearly in her right eye as she has in the past,should include questions about associated manifestations such as

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Associated manifestations of changes in visual acuity include the following: headache,rhinorrhea,sneezing,vertigo,"floaters" (spots of different sizes that float across the visual field and are caused by changes in the vitreous humor),flashes of light,aura,nausea and vomiting,generalized muscle weakness,eye pain or pressure,and infection (herpes simplex and cytomegalovirus).Therefore,the correct choice is eye pain and infection.Decreased moisture can be an associated manifestation of dryness of the eye which could be the result of decreased tear production.Aggravating factors associated with changes in visual acuity include allergens,stress,lack of sleep,decreased lighting,darkness (night),refractive changes,and systemic diseases.Sudden or gradual onset refers to the timing of the patient's inability to see clearly.

Your Examination of a Patient,who States That She Is Not