Acute Vision Loss Flashcards
what type of glaucoma causes acute vision loss
acute closed angle glaucoma
what is the pathology of acute closed angle gluacoma
increased intra-ocular pressure, resistance to aqueous flow at iridocorneal angle
is farsighted or shortsighted a risk factor for acute closed angle glaucoma
farsighted
is acute closed angle glaucoma more commonly unilateral or bilateral
unilateral
what are the main symptoms of acute closed angle glaucoma
pain, vomiting, headache, acute vision loss
what is seen on examination in acute closed angle glaucoma
injected scleral vessels
mid dilated pupil
cloudy cornea
what is the management of acute closed angle glaucoma
diamox then lazer procedure
what is the presentation of a retinal detachment
painless vision loss, floaters, curtain coming down
is shortsightedness or farsightedness a risk factor for retinal detachments
short sighted
what type of age related macular degeneration causes acute vision loss
wet type
what is the pathology of age related macular degeneration wet type
angiogenesis under retina leak blood
what is the presentation of age related macular degeneration wet type
decreased central vision acuity, metamorphopsia
what is the management of age related macular degeneration wet type
intravitreal anti-VEGF
what is the presentation of central retinal artery occlusion
profound painless monocular loss
what is seen on fundoscopy in central retinal artery occlusion
pale, cherry red spot, edematous retina, thread-like retinal vessels
what scan is used to determine the cause of central retinal artery occlusion
Carotid doppler
what is the management of central retinal artery occlusion with less than 24 hours since onset
ocular massage
what is the presentation of central retinal vein occlusion
painless moderate-severe monocular loss
what is seen on fundoscopy in central retinal vein occlusion
retinal haemorrhages, dilated tortuous veins, disc swelling, macular swelling, dark
what scan is used to diagnose a central retinal vein occlusion
OCT scan (??? true)
what is the management of a central retinal vein occlusion
intravitreal anti-VEGF
what is the pathology of ischaemic optic neuropathy
posterior ciliary artery occlusion causing optic nerve head infract
what is a cause of ischaemic optic neuropathy
giant cell arteritis of ophthalmic artery
what is seen on fundoscopy in ischaemic optic neuropathy
pale swollen disc
what is the presentation of ischaemic optic neuropathy
irreversible profound vision loss
what is amaurosis fugax
transient ophthalmic artery occlusion
what is the presentation of amaurosis fugax
curtain coming down less than 5 minutes
what is the management of amaurosis fugax
aspirin
what vessels are affected by giant cell arteritis
medium size ophthalmic / temporal artery
what age is most at risk of giant cell arteritis
elderly
what is the main presentation of giant cell arteritis
temporal tender headache, jaw claudication, weight loss, enlarged scalp arteries, amaurosis fugax
what condition do 50% of giant cell arteritis patients also have
polymyalgia rheumatica
what abnormalities are seen on blood tests in giant cell arteritis
increased ESR, CRP & PV
what test is diagnostic of giant cell arteritis
artery biopsy
what is the problems with biopsies in giant cell arteritis
lots of false negatives due to skip lesions
what is the management of giant cell arteritis
high dose oral steroids + PPI + aspirin
why do you give aspirin for giant cell arteritis
to decrease the risk of ischaemic optic nueropathy
what is a differential for acute vision loss
central retinal artery/vein occlusion, amaurosis fugax, ischaemic optic neurpathy, vitreous haemorrhage, retinal detachment, stroke, optic neuritis, wet ARMD, ACAG
what may be seen on examination in central retinal vein occlusion
rubeosis iridis
