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SS: Opthalmology > Common causes of Visual Loss > Flashcards

Common causes of Visual Loss Flashcards

1
Q

3 commonest causes of visual loss

A
  1. Cataract
  2. Glaucoma
  3. Age related Macular Degeneration
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2
Q

ARMD

A

Degenerative disorder of the macula affecting those over 50years. Irreversible

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3
Q

Dry ARMD

A
  • Accumulation of pigment epithelial waste products- Drusen
  • Atrophy of the retinal pigment epithelium
  • Slowly progressing
  • Less dramatic symptoms
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4
Q

Wet ARMD

A
  • Accumulation of fluid secondary to neovscularisation from pigment epithelial disruption
  • Haemorrhages, scarring, swelling
  • Can develop dramatically
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5
Q

ARMD risk factors

A

Age, smoking, sun exposure, poorly balanced diet, alcohol

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6
Q

ARMD symptoms

A

Blurring, scotoma, distortion, difficulty reading fine prinet, difficulty recognising faces, difficulty fine detail

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7
Q

AMRD signs

A

Distortion on Amsler grid testing, fundoscopy: drusen, atrophy, scarring and pigmentation, haemorrhages

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8
Q

Amsler Grid

A

A diagnostic tool that aids in the detection of visual disturbances cause by macular degeneration. Person looks with each eye separately at the small dot in the center of the grid. Patients with macular disease may see wavy lines or some lines may be missing.

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9
Q

Scotoma

A

A partial loss of vision or blind spot in an otherwise normal visual field

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10
Q

Treating ARMD

A
  • No Cure

- Lifestyle modification: smoking cessation, minimise prolonged sun exposure, diet

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11
Q

Drug that minimises angiogenesis for Wet ARMD

A

Lucentis (ranibizumab injection)

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12
Q

Anti-VEGF

A

Medication that block vascular endothelial growth factor

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13
Q

Cataract

A

Opacification of the lens

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14
Q

Symptoms of cataracts

A

gradual onset, blurred hazy vision, glare, haloes, monocular diplopia

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15
Q

Signs of cataracts

A

Reduced VA, Reduced red flex, poor view of fundus

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16
Q

Treating cataracts

A

Surgical phacoemulsification and intraocular lens implanation

17
Q

Glaucoma

A

Chronic structural optic neuropathy causing typical pattern of field loss
Linked to raised intraocular pressure
Runs in family- first degree relative positive history

18
Q

Second leading cause of blindness

19
Q

Symptoms of Glaucoma

A

Bumping into things, missing objects, visual acuity unaffected until end stage

20
Q

Signs of Glaucoma

A

Optic disc: cupping, pallor, plinter haemorrhages, raised intraocular pressure, confrontation fields, rAPD if asymmetric advanced glaucoma

21
Q

Investigating Glaucoma

A

Tonometry - inner eye pressure
Opthalmoscopy - shape and colour of the optic nerve
Perimetry - Complete field of vision
Gonioscopy - angle in the eye where the iris meets the cornea
Pachymetry - thickness of the cornea

22
Q

Medical treatment for Glaucoma

A

Topical ocular hypotensive agents

Carbonic anhydrase inhibitors

23
Q

Laser treatment for Glaucoma

A

Selective laser trabeculoplasty

24
Q

Surgical treatment for Glaucoma

A

Glaucoma filtration surgery

25
Q

Social treatment for Glaucoma

A
  • Counselling about compliance
  • Driving: patient to inform DVLA
  • IGA: International Glaucoma Association
26
Q

When to refer Glaucoma

A
  • non-urgent unless intraocular pressure is raised >30mmHg

- Acute angle closure glaucoma

27
Q

Acute Angle Closure Glaucoma

A

Ophthalmological emergency!

28
Q

Glaucoma medications: Prostaglandins analogue

A

Latranoprost, Bimatoprost, Travoprost

Increases uveoscleral outflow

29
Q

Side-effects of Prostaglandin analogues

A

Pigmentation, increase eyelash length, stinging, conjunctival injection

30
Q

Beta-blockers for glaucoma

A

Timolol
Reduces aqueous production
Avoid in Asthma, COPD, heat block

31
Q

Carbonic Anyhdrase inhibitors

A

Dorzolamide, Brinzolamide
Reduces aqueous production
Usually combined with Beta-blockers

32
Q

Selective a2 receptor agonists

A

Brimonidine, Iopidine
Reduces aqueous production
Avoid with MOI

33
Q

Side effects of selective a2 receptor agonists

A

Lethargy, dry mouth and eyes, allergy

34
Q

Combination therapies for glaucoma

A

Ganfort, Xalacom, Cospot, Combigan, Azarga

35
Q

Surgery for Glaucoma

A

Trabeculectomy +/- antimetabolite impants/shunts

36
Q

Laser for Glaucoma

A

Argon laser trabeculoplasty

Selective laser trabeculopasty

SS: Opthalmology (7 decks)

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