Eye Emergencies

Question 1

What are Charles Bonnet illusions?

Answer 1

Moths or other complicated illusions that occur in people with existing poor vision

Question 2

Does the retina have collateral supply?

Answer 2

No

Question 3

What causes spots and flickers in vision?

Answer 3

Separation of vitreous from the retina

• Occurs normally in life
• Can follow trauma

Question 4

How does giant cell arteritis present?

Answer 4

Headache

Scalp tenderness

Polymyalgia rheumatica

Jaw claudication

Question 4

What causes whizzes and zigzags?

Answer 4

Migraine

Question 5

Is the red reflex present in the embolism?

Answer 5

Yes

Question 7

How do retinal detachments arise?

Answer 7

An existing tear in the retina is infiltrated with vitreous

Question 8

What is the common cause of anterior ischaemic optic neuropathy?

Answer 8

Giant cell arteritis

Question 8

Why must spots and flickers be investigated?

Answer 8

They can indicate retinal tears

Question 9

What is the commonest cause of central retinal artery occlusion?

Answer 9

Atheroma

Question 10

What causes flashes?

Answer 10

Vitreous mobility - uniocular

Retinal ischaemia - uniocular

Cortical infarction - binocular (Posterior cerebral artery)

Question 12

Where is the commonest site of embolise?

Answer 12

Bification of the common carotid

Question 12

What do you see on the retina with central retinal artery occlusion?

Answer 12

Cherry red spot in contrast to opaque retina

Question 13

How do you Ix giant cell arteritis?

Answer 13

ESR

CRP

Superficial temporal artery biopsy

Question 15

How does the pupil behaviour with embolism?

Answer 15

No direct response

There will be consenual response

Question 16

How does retinal artery embolism present?

Answer 16

Sudden loss of vision

Painless

Question 17

What are common causes of transient vision loss?

Answer 17

TIA - particularly platelet emboli from the internal carotid

Vitreous haemorrhage

Question 18

Is oxygen therapy effective in embolism?

Answer 18

No

Question 19

How long can the retina last without blood supply?

Answer 19

A few hours

Question 20

What are the acute management goals in embolism?

Answer 20

Sudden lowering of intraocular pressure to cause a transient vasodilation so the embolise is dislodged

Question 21

What is anterior arteritic ischaemic optic neuropathy?

Answer 21

Any ischaemia in the posterior circulation of the globe that supplies the optic disc. This results in optic neuropathy (damage to the optic nerve) which causes vision loss associated with optic disc swelling