Eyes Flashcards
Features of central retinal vein occlusion
1) Sudden painless vision loss
2) Unilateral
3) Widespread cotton wool spots
4) Macular oedema
5) Rubeosis iridis
6) Retinal haemorrhages in all quadrants
7) RFs: smoking, HTN, DM, hyperlipidaemia
Features of central retinal artery occlusion
1) Sudden painless vision loss
2) Unilateral
3) Pale retina
4) “Cherry red spot”
5) RFs: atherosclerotic RFs–> HTN, DM, dyslipidaemia
Common causes of CRAO
1) Atherosclerosis
2) Embolic sources
3) Inflammatory causes- GCA
What is emergency Mx of CRAO
1) Rule out GCA (ESR, CRP)
2) Lie pt flat to help maintain circulation
3) Decrease IOP
Features of GCA
1) Headache
2) Scalp tenderness
3) Jaw claudication
4) A/w PMR
5) Acute unilateral vision loss
What is the Rx for GCA
Immediate oral pred (40-60mg/day) HIGH DOSE. Take a temporal artery biopsy.
Features of optic neuritis
1) Reduced VA
2) RAPD
3) Painful eye movements
4) Reduced colour saturation
5) Swollen inflammed disc due to papillitis
6) Blurred optic disc margins
7) Usually unilateral
NB: normal IOP
What are the 2 types of macular degeneration?
1) Wet
2) Dry
Which type of macular degeneration has no real Rx?
Dry
Features of dry macular degeneration
1) Gradual CENTRAL vision loss
2) Central scotoma
3) Painless
4) FHx of macular degen
5) Scarred fovea
RFs: age, smoking
What is the Mx of dry macular degeneration?
1) Mainly supportive
2) Stop smoking
3) Vitamin C and E supplementation
Which is more common, wet or dry AMD?
dry- 90%
Features of wet AMD
1) Rapid decrease in central vision (weeks- months)
2) Metamorphopsia
3) Central scotoma
4) Drusen
5) Scarred fovea
6) Intra-retinal haemorrhage
What is the Mx of wet AMD
Monthly intra-vitreal anti- VEGF injections
What is a RF for AMD?
Smoking
What is a complication of dry AMD?
Can become wet
Features of retinal detachment
1) Sudden visual loss
2) Painless
3) Flashers and floaters
4) On fundoscopy, may not see anything because it can be peripheral
5) Otherwise you would see that part of the retina is out of focus
NEEDS URGENT OPHTHAL REVIEW
What is RF for retinal detachment?
Myopes
Features of acute angle closure glaucoma
1) Unilateral red eye- sight threatening emergency
2) Throbbing pain of the eyebrow +/- radiation to forehead
3) Worsening vision loss
4) Mid-dilated pupil
5) Cloudy cornea
6) Shallow anterior chamber
7) Oval shaped pupil or tear drop shaped
8) Intra-occular pressures would be raised (60mmHg)
Mx of Acute angle closure glaucoma
1) IOP reduction
2) Acetazolamide STAT (IV and oral)
3) Topical BBs
4) Topical steroids
Features of chronic open angel glaucoma
- Gradual visual loss
- Can cause peripheral vision loss
- “Old pt complaining of not seeing things from side”
- Enlarged central cup “cupping” of optic nerve head
Features of cataracts
1) Gradual visual loss
2) Dullness of vision
3) VA that doesn’t improve with pinhole or glasses (old pt goes to get new prescription but this doesn’t help)
4) Absent or reduced red reflex indicates an opacity of the cornea (in this case lens)
5) Can be bilateral
RFs for cataracts
o Age
o Steroids
o DM
