Gradual Loss Of Vision 2

Question 1

Gradual loss of vision connotes reduction in vision in a _________ fashion over the course of _____________________.
This differs from reduction in vision that occurs over __________________________.

Answer 1

progressive

weeks, months or years.

minutes, hours or few days

Question 2

Classifying visual loss

List 4

Answer 2

◦ ◦ ◦ ◦
Sudden vs Gradual
Painless vs Painful
Unilateral vs Bilateral
Transient vs Permanent

Question 3

Causes of painless Gradual loss of vision

_________
_________
_________
Age-related _____________(AMD)
________ Retinopathy
Hereditary Retinal Dystrophies
Optic Nerve ___________
____________

Answer 3

Refractive error
Cataract
Glaucoma

Macular Degeneration

Diabetic ; Compression

Drug Toxicity

Question 4

Causes of painful Gradual loss of vision

____________ e.g Choroidal melanoma
___________ e.g chorioretinitis
Lesion of the _________ e.g granuloma or neuroma
________ problem e.g sarcoidosis or collegen vascular disease

Answer 4

Neoplastic; Inflammatory

Optic nerve

Systemic

Question 5

Age-related macular degeneration

AMD is a _______ degenerative disorder of the ______-rich ________ and ________ regions of the retina, seen in individuals aged ___ years and above, with resultant ______________________.

Answer 5

progressive; cone

macular ; peri-macular

50 ;loss of central visual acuity.

Question 6

AMD

The vision loss comes from ensuing ___________ because of ___________ dysfunction from damage to the _____________________ cells, the ___________ and the ___________

Answer 6

retinal atrophy ;photoreceptor

Retinal Pigment Epithelial(RPE)

chorio-capillaris

Bruch’s membrane.

Question 7

Causes of AMD

List 4

Answer 7

Atherosclerosis
Cigarette smoking
Dietary Factors- High fat intake and obesity Others like cataract surgery

Question 8

Classifications of AMD

________ (________)

________ (________)

Answer 8

Dry (non-exudative)

Wet(Exudative)

Question 9

Clinical features of AMD

_________________ of vision, especially _______ vision, over months and years. Both eyes ate usually affected, but often (symmetrical or asymmetrical.?)
Distortion of images called ____________

Answer 9

Gradual impaired

central; asymmetrical

metamorphopsia

Question 10

AMD

Signs seen include :

______________________ at interface btw the ______ and ____________

focal hypo/hyperpigmentation of RPE
Areas of ___________
Sub-RPE and sub-retinal _______ and retinal ________________

Answer 10

Deposition of extracellular materials

RPE and Bruch membrane,

RPE atrophy

Sub-RPE and sub-retinal blood and retinal lipid collection

Question 11

Treatment of AMD

Prophylaxis
___________
Use of intravitreal _______ agents
________ therapy
Low Vision aid

Answer 11

Amsler grid

anti-VEGF

LASER

Question 12

Diabetic retinopathy(DR) is a ___________ characterized by __________ , intraretinal ___________, _________, _______ spots and ______________

Answer 12

microangiopathy

microaneurysms

haemorrhages

hard exudates; cotton wool

neovascularization

Question 13

Diabetic Retinopathy

Divided into;

______________ DR
______________ DR

Answer 13

Non-proliferative DR

Proliferative DR

Question 14

Classification of diabetic retinopathy

Non proliferative Diabetic retinopathy
_________,________,________,__________

Proliferative Diabetic retinopathy
Diabetic _____________

Answer 14

mild moderate severe very severe

macular oedema

Question 15

Management of Diabetic Retinopathy

Management of DR is not solely that of the ophthalmologist
It needs a multidisciplinary approach
As strict diabetic control prevent and halt the progression of diabetic retinopathy
Also presence of nephropathy correlates well with diabetic retinopathy
Screening is very important

Answer 15

Sure

Question 16

Retinitis Pigmentosa

Retinitis Pigmentosa defines a clinically and genetically diverse group of diffuse retinal dystrophy initially predominantly affecting the _____________________ with subsequent degeneration of _________.

Answer 16

rod photoreceptor cells

cones

Question 17

___________ is the most commonly encountered hereditary fundus dystrophy in man.

Answer 17

Retinitis pigmentosa

Question 18

Retinitis pigmentosa

Epidemiology

Incidence of 1 in 5000 in the USA
No —————————— predilection
(Men or Women?) slightly more affected than (men or women?) due to ___________________

Answer 18

racial or sexual

Men; women

x linked inheritance

Question 19

Clinical classification of Retinitis Pigmentosa

Divided into 2 large groups:
- Non Syndromic Retinitis Pigmentosa: Disease process is _____________________________________

-Syndromic Retinitis Pigmentosa: Retinitis pigmentosa ___________________________

Answer 19

confined to the eyes with no other systemic manifestations

associated with other systemic diseases

Question 20

Clinical features of retinitis pigmentosa

Symptoms include ________ vision, Loss of ________ vision, presence of _______ vision

Signs include classic triad of ___________,_________________, and ___________

Other signs include tessellated fundus, macular atrophy, epiretinal membrane formation, CME

Answer 20

Poor night ; peripheral; tunnel

arteriolar attenuation, retinal bone-spicule pigmentation and waxy disc pallor

Question 21

Treatment of retinitis pigmentosa

GENETIC COUNSELLING
HIGH DOSE OF _________ 000U/DAY REFRACTION
_______ EXTRACTION
TREATMENT OF CME WITH ORAL ACETAZOLAMIDE
____________ AIDS
VOCATIONAL REHABILITATION/MOBILITY TRAINING
PYSCHOTHERAPY UV-ABSORBING SUNGLASSES

Answer 21

VIT A15

CATARACT

LOW VISION

Question 22

Optic nerve compression

This condition is (common or rare?) but should be considered if there is history of __________ and presence of any neurological or endocrinological abnormalities ,like ___________ , on examination

Answer 22

rare

headache

acromegaly,

Question 23

Optic nerve compression

Features:
________________ pupillary defect
________ or ___________ optic disc
Visual abnormalities like __________ defects

Answer 23

Relative afferent

Pale or oedematous

bitemporal