Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Ophthal > Acute Visual Loss (Painless) > Flashcards

Acute Visual Loss (Painless) Flashcards

1
Q

What are the conditions that causes painless acute visual loss?

A
  1. Central retinal artery occlusion
  2. Ischemic central retinal vein occlusion
  3. Massive vitreous hemorrhage
  4. Retinal detachment involving macular area
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is central retinal artery occlusion?

A

Obstruction to arterial circulation of retina at lamina cribrosa
- unilateral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the causes of central retinal artery occlusion?

A
  1. Embolus/thrombosis + artery spasm
  2. HTN
  3. Arteriosclerosis
  4. Angiospasm
  5. Temporal arteritis
  6. Thrombophillic disorder
  7. Raised IOP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the types of emboli seen?

A
  1. Cholesterol = orange at retinal vessel bifurcation
  2. Calcium = white from cardiac valves
  3. Fibrin = dull white from atheromas in carotid artery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the symptoms of CRAO?

A
  1. Sudden painless loss of vision (over sec)
  2. H/o transient vision loss (amourosis fugax) in past
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What happens to the visual acuity in CRAO?

A

Reduces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What happens to the direct pupillary light reflex in CRAO?

A

Absent
RAPD +ve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is found in fundus examination for CRAO?

A
  1. Narrowing in retinal arteries
  2. Cherry red spot fovea (choroid shining through retina)
  3. Milky white retina (edema)
  4. Cattle track blood vessels
  5. Narrow arterioles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is found in FFA (fundus fluorescein angiography) for CRAO?

A
  1. Delayed arterial filling
  2. Masking of choroidal vasculature
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the management for CRAO?

A
  1. Immediate lowering IOP
  2. Vasodilator
  3. Fibrinolytics
  4. Inhalation of mixture 95% O2 + 5% CO2
  5. IV steroids
  6. Laser photodisruption of embolus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How is done for immediate lowering of IOP?

A
  1. Intermittent ocular massage
  2. IV mannitol
  3. Paracentesis of ant chamber
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the prognosis for CRAO?

A
  • Full visual recovery + amaurosis fugax
  • If its prolonged arterial occlusion = severe, unrecoverable visual loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the complications in CRAO?

A
  1. Complete blindness
  2. Thrombotic/neovascular glaucoma due to retinal ischemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the DDs of cherry red spot?

A
  1. Tay Sachs disease
  2. Niemann Pick disease
  3. Myoclonus
  4. Berlin’s edema
  5. Macular hole/hemorrhage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the 2 types of central retinal vein occlusion (CRVO)?

A
  1. Ischemic
  2. Non-ischemic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are causes of CRVO?

A
  1. Pressure on vein by atherosclerotic artery
  2. Hyperviscosity of blood (polycytemia)
  3. Periphlebitis retinae (SLE, sarcoidosis)
  4. Raised IOP (glaucoma)
  5. Local causes = tumor
  6. HTN & DM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Comment about the vision and RAPD in ischemic CRVO

A
  1. Marked sudden visual loss
  2. RAPD +ve
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the findings in fundus examination in early stage ischemic CRVO?

A
  1. Massive engorgement, congestion & tortuosity of vein
  2. Massive retinal hemorrhages (splashed tomato appearance)
  3. > 6-10 cotton wool spots
  4. Disc : edema, hyperemia
  5. Macula: hemorrhagic, severely edematous
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the findings in fundus examination in late stage ischemic CRVO?

A
  1. Neovascularization
  2. Macula: Chronic cystoid edema
  3. Marked sheathing of veins around disc
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Comment about the vision and RAPD in non-ischemic CRVO

A
  1. Mild to moderate visual loss
  2. RAPD absent
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the findings in fundus examination in early stage non-ischemic CRVO?

A
  1. Mild venous congestion & tortuosity
  2. Superficial flame haemorrhage peripherally
  3. Mild papilloedema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the findings in fundus examination in late stage non-ischemic CRVO?

A
  1. Sheating around main vein
  2. Retinal haemorrhage are partly absorbed
23
Q

What are the ocular investigations to be done in CRVO?

A
  1. Visual acuity
  2. IOP checkup
  3. Undilated slit lamp examination - detect neovascularization of iris
  4. Gonioscopy/fundus examination
  5. Goldmann perimetry and ERG evaluation
    - differentiate ischaemic & non ischaemic
24
Q

What are the systemic investigations to be done in CRVO?

A

Look for HTN, DM, heart disease, dyslipidemia, hypercoagulative disorders & homocysteinosis

25
What is the ocular therapy done in CRVO?
- 1.25mg intravitreal anti-VEGFs (bevacizumab) OR - intravitreal triamcinolone (1mg/0.1ml) - laser therapy - surgery = pars plana vitrectomy
26
What are the complication in CRVO?
1. Rubeosis iridis 2. Neovascular glaucoma 3. Vitreous haemorrhage 4. Proliferative retinopathy
27
What is the anatomical location of massive vitreous hemorrhage?
- Occurs from the retinal vessels - Present as preretinal/intragel hemorrhage (anterior, middle, posterior or whole vitreous body)
28
What are the etiologies of massive vitreous hemorrhage?
1. Trauma 2. Central retinal vein thrombosis 3. Malignant HTN 4. DM 5. Vitreous reaction 6. Eale’s disease = retinal vasculitis, periphlebitis 7. Blood dyscrasia = leukemia
29
What are the symptoms of massive vitreous hemorrhage?
1. Sudden onset floaters (small hemorrhage) 2. Loss of vision (massive hemorrhage)
30
What are the signs in distant direct ophthalmoscopy for massive vitreous hemorrhage?
1. black shadow against red glow (small haemorrhage) 2. no red glow (large haemorrhage)
31
What are the signs in direct & indirect ophthalmoscopy for massive vitreous hemorrhage?
1. blood in vitreous (small haemorrhage) 2. non-visualization of fundus (large haemorrhage)
32
What are the signs in slit lamp examination for massive vitreous hemorrhage?
reddish mass in vitreous
33
What is the duration of complete absorption in vitreous hemorrhage?
4-8 weeks
34
What is the sign of recurrent bleeding in vitreous hemorrhage?
organization of hemorrhage into yellow white debris
35
What is the complications in vitreous hemorrhage?
liquefaction degeneration
36
What is the conservative treatment in vitreous hemorrhage?
Bed rest + head elevation
37
What is the definitive treatment in vitreous hemorrhage?
1. Photocoagulation (if new vessels seen in retina) 2. Vitrectomy (done after 3-6 months if no visual impairment & vision is reduced to only light perception/hand movements)
38
What is retinal detachment (involving macula area)?
Separation of neurosensory retina proper from the pigment epithelium
39
What is rhegmatogenous/primary RD?
Retinal break (tear/hole) through which subretinal fluid seeps & separates the sensory retina from pigmentary epithelium
40
What is tractional retinal detachment?
Retina being mechanically pulled away from its bed by contraction of fibrous tissue in the vitreous (vitreoretinal fibrous bands)
41
What is exudative retinal detachment?
Retina being pushed away by neoplasm or accumulation of fluid beneath the retina following inflammatory or vascular lesions
42
What are the prodromal symptoms of RD?
1. Floaters 2. Photopsia
43
What are the visual symptoms of RD?
1. Localized relative loss of field of vision 2. Dark cloud/veil in front of eyes
44
What pupillary abnormality is seen in RD?
RAPD +ve
45
What are the findings on distant direct ophthalmoscopy in RD?
Altered red reflex
46
What are the ophthalmoscopic finding in RD?
1. Grey reflex 2. Reddish retinal breaks of various shapes
47
What are the features of exudative RD?
1. Smooth & convex detachment 2. Shifting fluid 3. Opaque on transillumination
48
What are the features of tractional retinal detachment?
1. Vitreoretinal bands with lesions 2. Detached area is concave 3. Highest elevation of retina at site of traction
49
What is the primary method to seal retinal breaks?
Cryocoagulation
50
How is subretinal fluid managed in RD?
Drainage of subretinal fluid
51
What are the methods to maintain chorioretinal apposition?
1. Scleral buckling 2. Pnematic retinopexy
52
How is vitreous traction reduced in RD?
1. Internal/external tamponade 2. Vitrectomy
53
How is RD due to Intraocular tumors treated?
Enucleation of tumors

Ophthal (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions