Acute Loss Of Vision Flashcards
Sudden painless loss of vision means lesion in …..
Optic nerve
Stroke of eye is ?
Central retinal artery occlusion
Types of arterial and vein occlusive disease
Central Retinal Artery/ vein Occlusion (CRAO,CRVO)
Branch Retinal Artery/vein Occlusion (BRAO,BRVO)
Etiology of CARO
Embolic
Thrombotic
Compression
Important source of retinal emboli and the clinical findings
atherosclerotic disease of the carotid arteries, cherry red spots
Types of emboli
Calcific (cardiac)
Platelet - fibrin (carotid)
Cholesterol (carotid)
What causes PAN and SLE
Branch artery occlusion
Haematological disorders that cause haematogical disorders
Protien s and c deficiency
Antithrombin 3 deficiency
Sticky platelet syndrome and anti phospholipid antibody syndrome
CRAO is common in patients with systemic diseases like
Hypertension 60%
Carotid artery disease 50%
Diabetes mellitus 25%
Cardiac valve disease 35%
cause of SARO in patients less than 30 yrs of age
Migraine
Coagulation abnormalities
Cardiac disorders
Trauma
Symptoms of CRAO
Sudden, painless loss of vision
Transient vision loss . Amaurosis Fugax
Signs
• Relative Afferent Pupillary defect
• Fundus – Initial few minutes, normal
• Retinal Opacification
• Cherry red spot
• Box Carring of arterioles
• Thin arterioles
Treatment
Ocular massage
Decrease intraocular massage Acetazolamide
Timolol
Mannitol
Anterior Chamber Paracentesis
O2 95% + CO2 5% administration – to dilate the
vessels or breath into a bag
Signs of crvo + type
Critical .Diffuse retinal hemorrhages in all
four quadrants of the retina; dilated,
tortuous retinal veins. (Non Ischemic)
Other .Cotton–wool spots; disc edema and
hemorrhages; retinal edema; optociliary
shunt vessels on the disc;
neovascularization of the optic disc (NVD),
retina (NVE), iris (NVI), and angle (NVA) [ischemic]
Retinal vein occlusion
Increase age
Periphlebitis
Treatment crvo
Non Ischemic CRVO
Observation
Ischemic CRVO
PRP if NVI develops
Prophylactic PRP is usually not
recommended unless follow-up is in doubt.
Pan Retinal Photocoagulation is the standard
treatment for
NVD/NVE/NVI
Classification of retinal detachment
Rhegmatogenous retinal detachment
results from a tear, i.e., a break in the
retina.
Tractional retinal detachment results
from traction, i.e., from vitreous strands
that exert tensile forces on the retina.
Exudative retinal detachment is caused
by fluid. Blood, lipids, or serous fluid
accumulates between the neurosensory
retina and the retinal pigment epithelium.
Coats’ disease is a typical example.
Rhegmatogenous RD Symptoms
Symptoms of PVD
Flashes of light, Floaters
Symptoms of RD
Sudden decrease in vision
(If RD is Superior)
Gradual decrease in vision
(IF RD is Inferior)
Rhegmatogenous RD Examination
findings
Grayish appearance of the retina with folds which show
oscillations with movement of the eye
Loss of choroidal reflexes
Dark appearing blood vessels
Risk factors
Myopia >5D - 2.4%
• Aphakia, Pseudophakia
• Lattice degeneration
Treatment for RRD
- Localization of the retinal breaks
- Sealing the breaks (Cryoretinopexy/Laser photocoagulation)
- Chorioretinal Apposition
- Drainage of sub-retinal fluid
Chorio-retinal Apposition
methods
External tamponade
Silicone buckle, encirclage sponge
Internal tamponade
• Pneumatic Retinopexy
Gas-Air
Sulphur Hexa Fluoride(SF6)
Perfluoropropane(C3F8)
• Silicon oil
Treatment principles of complicated RD
Three Port Pars Plana Vitrectomy (TPPV)
and Silicon Oil Tamponade
Diseases causing tractional retinal detachment
• Proliferative diabetic retinopathy
• Eales disease
• Trauma with or without Foreign Body.
• Retinopathy Of Prematurity
Diseases causing exudative retinal
detachment:
Inflammatory:
Haradas disease
Posterior Scleritis
• Systemic
Eclampsia
Hypertension
• Tumors
Melanoma
Retinoblastoma
