Gradual Loss Of Vision 2 Flashcards
Gradual loss of vision connotes reduction in vision in a _________ fashion over the course of _____________________.
This differs from reduction in vision that occurs over __________________________.
progressive
weeks, months or years.
minutes, hours or few days
Classifying visual loss
List 4
◦ ◦ ◦ ◦
Sudden vs Gradual
Painless vs Painful
Unilateral vs Bilateral
Transient vs Permanent
Causes of painless Gradual loss of vision
_________
_________
_________
Age-related _____________(AMD)
________ Retinopathy
Hereditary Retinal Dystrophies
Optic Nerve ___________
____________
Refractive error
Cataract
Glaucoma
Macular Degeneration
Diabetic ; Compression
Drug Toxicity
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
Neoplastic; Inflammatory
Optic nerve
Systemic
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 ______________________.
progressive; cone
macular ; peri-macular
50 ;loss of central visual acuity.
AMD
The vision loss comes from ensuing ___________ because of ___________ dysfunction from damage to the _____________________ cells, the ___________ and the ___________
retinal atrophy ;photoreceptor
Retinal Pigment Epithelial(RPE)
chorio-capillaris
Bruch’s membrane.
Causes of AMD
List 4
Atherosclerosis
Cigarette smoking
Dietary Factors- High fat intake and obesity Others like cataract surgery
Classifications of AMD
________ (________)
________ (________)
Dry (non-exudative)
Wet(Exudative)
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 ____________
Gradual impaired
central; asymmetrical
metamorphopsia
AMD
Signs seen include :
______________________ at interface btw the ______ and ____________
focal hypo/hyperpigmentation of RPE
Areas of ___________
Sub-RPE and sub-retinal _______ and retinal ________________
Deposition of extracellular materials
RPE and Bruch membrane,
RPE atrophy
Sub-RPE and sub-retinal blood and retinal lipid collection
Treatment of AMD
Prophylaxis
___________
Use of intravitreal _______ agents
________ therapy
Low Vision aid
Amsler grid
anti-VEGF
LASER
Diabetic retinopathy(DR) is a ___________ characterized by __________ , intraretinal ___________, _________, _______ spots and ______________
microangiopathy
microaneurysms
haemorrhages
hard exudates; cotton wool
neovascularization
Diabetic Retinopathy
Divided into;
______________ DR
______________ DR
Non-proliferative DR
Proliferative DR
Classification of diabetic retinopathy
Non proliferative Diabetic retinopathy
_________,________,________,__________
Proliferative Diabetic retinopathy
Diabetic _____________
mild moderate severe very severe
macular oedema
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
Sure
Retinitis Pigmentosa
Retinitis Pigmentosa defines a clinically and genetically diverse group of diffuse retinal dystrophy initially predominantly affecting the _____________________ with subsequent degeneration of _________.
rod photoreceptor cells
cones
___________ is the most commonly encountered hereditary fundus dystrophy in man.
Retinitis pigmentosa
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 ___________________
racial or sexual
Men; women
x linked inheritance
Clinical classification of Retinitis Pigmentosa
Divided into 2 large groups:
- Non Syndromic Retinitis Pigmentosa: Disease process is _____________________________________
-Syndromic Retinitis Pigmentosa: Retinitis pigmentosa ___________________________
confined to the eyes with no other systemic manifestations
associated with other systemic diseases
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
Poor night ; peripheral; tunnel
arteriolar attenuation, retinal bone-spicule pigmentation and waxy disc pallor
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
VIT A15
CATARACT
LOW VISION
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
rare
headache
acromegaly,
Optic nerve compression
Features:
________________ pupillary defect
________ or ___________ optic disc
Visual abnormalities like __________ defects
Relative afferent
Pale or oedematous
bitemporal
