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Ophthalmology RIA > Central retinal artery occlusion + Central retinal vein occlusion > Flashcards

Central retinal artery occlusion + Central retinal vein occlusion Flashcards

1
Q

Risk factors of CRAO?

A
  • hypercholesterolaemia
  • hypertension
  • atherosclerosis
  • Diabetes mellitus
  • Fhx vascular problems
  • smoking hx
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2
Q

clinical presentation of CRAO?

A

painless unilateral loss of vision described as a curtain coming down

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3
Q

examination findings in CRAO?

A
  • no pupillary response (if complete occlusion)
  • RAPD
  • visual fields reduced/loss (depending on the extent of occlusion)
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4
Q

Findings on fundoscopy if the retina infarct in CRAO?

A
  • oedematous
  • pale retina
  • cherry red spot
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5
Q

why does a cherry red spot appear?

A

the cherry red spot appears because the macula receives its blood supply from the choroid, supplied by the long and short posterior ciliary arteries (which are not affected by the central retinal artery occlusion) whereas the rest of the retina is perfused by the central retinal artery

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6
Q

Management of CRAO?

A
  • Emergency referral to ophthalmology
  • Treatment to lower IOP
  • Orbital massage (to attempt to dislodge the clot)
  • Vasodilators
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7
Q

Medications to lower intra ocular pressure?

A
  • Acetozolamide

- Mannitol

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8
Q

what are the main arteries that supply the eye?

A
  • central retinal artery

- posterior ciliary arteries

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9
Q

what does the central retinal artery supply?

A
  • superior nerve fibre layer

- inner 2/3 of retina

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10
Q

what does the posterior ciliary artery supply?

A
  • macula
  • remainder of anterior optic nerve
  • uvea: iris, ciliary body, choroid (deep retinal layers)
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11
Q

central retinal artery occlusion results in ischaemias of ___

A

ischaemia of inner retinal layers which therefore results in oedema of the nerve fibre layers

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12
Q

3 symptoms of CRAO?

A
  • painless loss of vision
  • profound drop in visual acuity
  • RAPD
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13
Q

6 potential causes of CRAO?

A
  • arteritis
  • atheroma
  • embolus
  • migraine
  • syphilis
  • herpes zoster
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14
Q

prophylatic treatment for CRAO?

A
  • aspirin

- statin

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15
Q

what is done on follow up?

CRAO

A

assess for

  • carotid bruit
  • heart murmur
  • carotid doppler ultasound
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16
Q

3 causes of central retinal vein occlusion?

A
  • glaucoma
  • polycythaemia
  • hypertension
17
Q

examination findings in CRVO?

A 
Fundoscopy 
- flame haemorrhages 
- swollen disc 
- retinal cotton wool spots 
RAPD
18
Q

what causes intra retinal haemorrhages and retinal oedema in CRVO?

A

the affected vein being tortuous and dilated

19
Q

what can lead to glaucoma in CRVO?

A

neovascularisation of the iris

Ophthalmology RIA (13 decks)

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