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Opthalmology > Acute and Chronic Visual Loss > Flashcards

Acute and Chronic Visual Loss Flashcards

1
Q

What visual acuity is deemed as blind?

A

< 3/60 in the better eye

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2
Q

What is the most common cause of blindness in the world?

A

Cataracts

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3
Q

What visual acuity can you not drive beyond?

A

6/12

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4
Q

The closer the cataract is to the _____ part of the eye, the worse the cataract is

A

Nodal

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5
Q

Is a cataract better in bright or dim light? Why?

A

Dim light

Some of the light may get passed the opacity due to the dilated pupil

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6
Q

What happens to the lens with increasing age?

A

It grows

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7
Q

What is the triad of congenital rubella?

A

Sensory problems
Cataracts
Heart problems

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8
Q

What is an autosome?

A

A non sex chromosome

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9
Q

What is the commonest cause for amblyopia?

A

Refractive error

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10
Q

What is the vascular layer of the eye?

A

Uvea

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11
Q

What can uveitis cause?

A

Cataracts

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12
Q

What can steroids for an inflammatory condition cause?

A

Cataracts

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13
Q

What is the eye very sensitive to?

A

Trauma

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14
Q

Cataracts can make you not see what colour?

A

Blue

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15
Q

What happens to the refractive index of the lens in cataracts and what does this result in?

A

Increased
Leads to increased bending of light
So focuses in vitreous

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16
Q

What is index myopia?

A

Presbyopia

Goes away and then cant see far away

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17
Q

What holds the lens from the Ciliaris muscle?

A

Zonules

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18
Q

Where does the aqueous humour exit the eye?

A

Via the trabecular meshwork

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19
Q

Where is the aqueous humour made?

A

Ciliary body

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20
Q

What is the sensitive part of the eye?

A

Macula

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21
Q

What is the central part of the macula called? What is the features of the fibres of this?

A

Fovea

The fibres are spread apart so that light can go directly on the retina

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22
Q

Where is the blind spot?

A

On the optic nerve

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23
Q

Why is the optic nerve a blind spot?

A

As the fibres dont let the light through

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24
Q

What is a scitoma?

A

A non seeing area

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25
Q

What does a non -ve scitoma in glaucoma mean?

A

They are unaware that they cant see

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26
Q

What do beta blockers do in the treatment of glaucoma?

A

Stop production

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27
Q

What do prostaglandins do in the treatment of glaucoma?

A

Help the drainage

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28
Q

How does a trabeculectomy work?

A

Fluid comes through the iris and through a trap door (fistula)

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29
Q

What would be seen in endophlemitis?

A

Pus in the eye

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30
Q

What is absent in closed angle glaucoma?

A

Light reflex

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31
Q

Presentation of closed angle glaucoma

A 
Absent light reflex
Mid dilated pupil 
Vomiting
Abdominal pain 
Extreme pain in eye 
Red eye
32
Q

Why does closed glaucoma cause vomiting and abdominal pain?

A

Due to stimulation of the vagal nerve

33
Q

Cause of a pale retina

A

Central retinal artery occlusion

34
Q

What does a cherry red spot mean?

A

Infarcts except from at fovea, as see choroid circulation

35
Q

Where is the most likely source of an eye embolus?

A

Carotids

36
Q

What does CRAO stand for?

A

Central retinal artery occlusion

37
Q

Treatment of CRAO

A 
Diamox
Massage
Topic glaucoma medications
AC parenthesis 
Increased pCO2
38
Q

What is the aim of treatment of CRAO?

A

Lower IOP to try and move the embolus along

39
Q

Why is pCO2 treated to increase in CRAO?

A

Increased vasodilation

40
Q

How is pCO2 increased?

A

Breath into a paper bag

41
Q

Risk factors for a vein occlusion in the eye

A 
HTN
DM
Smoking
Increased IOP
Blood conditions e.g. myeloma
42
Q

What does VEGF do?

A

Promotes new vascular growth in the eye when there is ischaemia

43
Q

Treatment of rubeosis Iridis

A

Laser - gets rid of vessels
Elimination of Veg F
Steroids

44
Q

Investigations of temporal arteritis

A

CRP

Biopsy

45
Q

What condition overlaps with temporal arteritis?

A

Polymyalgia rheumatica

46
Q

Treatment of temporal arteritis

A

High dose of prednisolone quickly

47
Q

What can happen if temporal arteritis is not treated?

A

Can become blind in one eye and spread to the other

48
Q

What does PH stand for?

A

Pinhole

49
Q

How are cataracts named?

A

Depending on where is affected

50
Q

Will a true cataract recur? What can happen?

A

No

but epithelial cells can proliferate and thicken the capsule again - however this is not cataracts

51
Q

How common is hypopia?

A

Rare

52
Q

Pathology of hypopia

A

Fluid level of pus in the anterior chamber

53
Q

What is a hypopia?

A

Intraocular infection

54
Q

What may a hypopia need?

A

Vitrectomy

55
Q

Prognosis of hypopia

A

Poor

56
Q

Who gets hypopia?

A

Trauma

Immunocompromised

57
Q

On looking at an eye, how can you tell which vessels are arteries and which are veins?

A

Blood is darker in the arteries

58
Q

What is the distribution of symptoms of a branched retinal vein occlusion?

A

Just in the quadrant

59
Q

Types of retinal vein occlusion

A

Central

Branched

60
Q

Features of central retinal vein occlusion

A

Sudden loss of vision in affected eye
Blot haemorrhages
Begorged veins
Red/erythematous optic disc

61
Q

What condition has the same eye symptoms as central retinal vein occlusion but look different clinically?

A

Central retinal artery occlusion

62
Q

Features of the eye in central retinal artery occlusion

A

Cherry red spot

Pale retina

63
Q

What is usually associated with central retinal vein occlusion?

A

HTN

64
Q

What is usually associated with central retinal artery occlusion?

A

Embolus

Hypoperfusion

65
Q

What can cause CRAO and therefore what must be checked?

A

GCA

Inflammatory markers and any other symptoms

66
Q

What is the most common cause of blindness in the UK?

A

Age related macular degeneration

67
Q

What is ARMD characterised by?

A

Degeneration of retinal photoreceptors that results in the formation of drusen which can be seen on fundoscopy and retinal photography

68
Q

Two types of macular degeneration

A

Dry (90%) vs Wet (10%)

Early vs late

69
Q

What is dry macular degeneration characterised by?

A

Drusen-yellow round spots in Bruch’s membrane

Geographic atrophy

70
Q

What is wet macular degeneration characterised by?

A

Exudative and choroidal neoavascularisation

Leakage of serous fluid and blood can subsequently result in a rapid loss of vision

71
Q

Which is the type of macular degeneration has the worst prognosis?

A

Wet

72
Q

RFs for age related macular degeneration

A 
Advancing age 
Smoking
FH
HTN
Dyslipidaemia
DM
73
Q

Presentation of age related macular degeneration

A 
Reduction in visual acuity
Difficulties seeing in the dark 
Fluctuations (day to day) in visual disturbance 
Photopsia 
Glare around objects
74
Q

What is photopsia?

A

A perception of flickering or flashing lights

75
Q

Signs of age related macular degeneration

A

Disortortion of line perception
Fundoscopy
- drusen
- yellow areas of pigment deposition in the macular area
In wet
- well demarcated red patches may be seen (intra retinal or sub retinal fluid leakage or haemorrhage)

76
Q

Investigations of age related macular degeneration

A

Slit lamp
Flurorescein angiography
Ocular CT

77
Q

Treatment of age related macular degeneration

A

Moderate dry category ARMD
- zinc + anti oxidant vitamins A, C and E
anti-VEGF
Laser photocoagulation

Opthalmology (8 decks)

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