Exam 1 - Decreased vision Flashcards
Is a retinal detachment a medical emergency?
Yes, it is a medical emergency
- Keep NPO for surgical treatment
Retinal detachment symptoms
- Photopsia (flashing lights)
- Visual field defects
- Floaters
Retinal detachment risk factors
- High myopia (severe nearsightedness)
- Trauma or prior eye surgery
- Vascular disease
- Vitreous disease or degeneration
Fundoscopic exam of retinal detachment: findings
- Elevation of retina
- Gray with dark blood vessels that lie in folds
Retinal detachment differential diagnoses
- Migraine with aura
- Vitreous detachment
- Retinal artery or vein occlusion
What is optic neuritis? Is it a medical emergency?
Demyelination of optic nerve
- Refer right away to ER or ophthalmologist
- Will need IV then oral steroids, brain MRI or optic nerve MRI
Optic neuritis symptoms
- Preceding viral infection
- Pain with eye movement
- Dyschromotopsia (change in color perception)
- Vision loss worse with heat or exercise
- Objects appear curved
Optic neuritis exam findings
- Pupil light reflex decreased
- May have decreased visual acuity
- Abnormal color vision
- Central scotoma
- Swollen optic disc
What is amaurosis fugax?
Transcient monocular loss of vision d/t ischemia of retinal choroid and optic nerve, or giant cell arteritis
- Subform of TIA
How would patients describe their visual field with amaurosis fugax?
Gray curtain from periphery to central that lasts 2-30 minutes
What causes amaurosis fugax?
Due to plaque in the carotid artery
- Monocular
Amaurosis fugax is more common with what type of patients?
More common in adults over 45 years old
Amaurosis fugax diagnostic testing and imaging
- Cardiovascular evaluation
- Hypercoagulability work up
- Carotid ultrasound
- Assess for TIA symptoms
Amaurosis fugax differential diagnosis
Retinal artery occlusion (similar symptoms but more persistent)
