Chapter 2 - Acute Vison Loss

Question 1

Marcus Gunn pupil

Answer 1

Relative afferent pupillary defect

Question 2

Tonometry

Answer 2

measurement of IOP

Question 3

Hyphema

Answer 3

Blood in the anterior chamber.

Question 4

Causes of acute visual loss

Answer 4

Media opacities of clear refractive media of eye (cornea, anterior chamber, lens, vitreous); Corneal edema, Hyphema, Cataract, VItreous hemorrhage

Question 5

Retinal disease

Answer 5

Retinal detachment, Macular disease, Retinal vascular occlusion, CRAO

Question 6

BRAO

Answer 6

Branched retinal artery occlusion - only a sector of retina opacifies and visual only partially lost. More likely due to embolus than CRAO

Question 7

CRVO

Answer 7

Central retinal vein occlusion (CRVO) - blood and thunder, older patietns with HTN, arteriosclerotic vascular disease. Dilated and tortuous veins, flame shaped hemorrhages, cotton-wool spots.

Question 8

Optic nerve disease

Answer 8

Optic neuritis, retrobulbar optic neuritis

Question 9

Papillitis

Answer 9

Inflammation of optic disc

Question 10

Papilledema

Answer 10

Swelling of the optic disc from increased intracranial pressure. Both optic discs are affected.

Question 11

Papilledema vs optic neuritis

Answer 11

ON - vison significantly decreased, pupils with relative afferent pupillary defect. Papillledema, VA and pupillary reflexes normal. Both show blurred optic disc margins and optic disc cupping.

Question 12

Ischemic optic neuropathy

Answer 12

Swelling of disc and visual loss from vascular event with PALE SWOLLEN DISC and often with splinter hemorrhages and loss of VA and VF. often superior or inferior field, altitudinal.

Question 13

Carotidynia

Answer 13

Ear or antieror neck discomfort

Question 14

Presentation of GCA

Answer 14

Giant cell arteritis - pain resting on pillow, scalp tenderness with brushing hair, carotidynia, fatigue or pain of tongue or jaw chewing (claudication), transient diplopia or visual loss, orexia, weight lsos, general malaise, aching fatigue of upper arms or legs (PR)

Question 15

Cortical blindness

Answer 15

Rare, central or cerebral blindness - normal pupillary reactions. Normal fundus.

Question 16

What is functional used to describe

Answer 16

visual loss without organic basis. hysterical or malingering.

Question 17

Name ACUTE causes of VL that require urgent referral.

Answer 17

RD, acute CRAO, ischemic optic neuropathy if suspected to be related to GCA.

Question 18

Sudden reduced acuity, clear ocular media, relative afferent pupillary defect, and swollen optic disc in healthy young woman

Answer 18

OPTIC NEURITIS, retrobulbar optic neuritis

Question 19

Treatment GCA

Answer 19

GCA - obtain ESR, CRP, Rx high dose corticosteroids.

Question 20

Photopsia

Answer 20

flashing lights