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Year 4: Opthalmology > Gradual Vision Loss > Flashcards

Gradual Vision Loss Flashcards

1
Q

pneumonic for causes of gradual vision loss

A

CARDIGAN

Cataracts

Age related macular degeneration (dry)

Refractive Error

Diabetic Retinopathy

Inherited Disease

Glaucoma (Open angle)

Access to eye clinic (non-urgent)

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2
Q

what is cataracts

A

gradual clouding of the lens

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3
Q

what can cause cataracts

A

age related - denaturing of lens protein as part of ageing

congenital - screened for with red reflex during neonatal exam

diabetes

steroids

trauma

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4
Q

key sign in cataracts

A

diminished/ loss of red reflex

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5
Q

symptoms of cataracts

A

gradual painless decrease in visual acuity

faded colour vision

glare - lights seem brighter

haloes around lights, particularly at night

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6
Q

treatment of cataracts

A

cataract surgery - removal of lens and replacing with artificial one

  • endopthalmitis is a rare but serious complication
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7
Q

pathological hallmark of dry age related macular degeneration

A

drusen - yellow deposits of lipids / proteins

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8
Q

symptoms of dry age related macular degeneration

A

gradual painless loss of central vision

distortion of straight lines

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9
Q

management of dry age related macular degeneration

A

irreversible damage - treatment based on supporting the remaining vision the patient has left

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10
Q

what is a refractive error

A

eye’s inability to clearly focus on an image

e.g. hypermetropia, myopia, astigmatisms

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11
Q

what is astigmatism? what are the symptoms?

A

abnormal curvature of the cornea

  • causes two focal points of light on the retina instead of one

blurry vision, headaches, eye strain

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12
Q
A
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13
Q

how is a refractive error corrected

A

glasses

contact lenses

laser eye surgery for permanent correction of vision

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14
Q

pathophysiology of diabetic retinopathy

A

hypercalcaemia causes:

  • epithelial dysfunction: increased vascular permeability – haemorrhages + exudate formation
  • pericyte dysfunction: microaneurysms
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15
Q

classifications of diabetic retinopathy

A

non-proliferative (mild, moderate, severe)

proliferative

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16
Q

what is seen in mild diabetic retinopathy

A

microanuerysms

17
Q

what is seen in moderate diabetic retinopathy

A

microanuerysms

blot haemorrhages

hard exudates

cotton wool spots

18
Q

what is seen in severe diabetic retinopathy

A

blot haemorrhages

microaneurysms in 4 quardrants

venous bleeding in 2 quadrants

intraretinal microvascular abnormality (IRMA) in any quadrant

19
Q

features of proliferative diabetic retinopathy

A

neovascularisation

vitreous haemorrhage

20
Q

complications of diabetic retinopathy

A

retinal detachment

vitreous haemorrhage

optic neuropathy

cataracts

21
Q

treatment of diabetic retinopathy

A

laser photocoagulation

anti-VEGF

Vitreoretinal surgery in very severe disease

22
Q

what is diabetic maculopathy

A

macula oedema + ischaemic changes

tx: laser surgery

23
Q

what causes an open angle glaucoma

A

gradual rise in IOP due to resistance in the trabecular meshwork

24
Q

risk factors for open angle glaucoma

A

increased age

myopia

black ethnicity

family history

25
Q

symptoms of open angle glaucoma

A

gradual decrease in peripheral vision – tunnel vision

gradual onset of fluctuating headaches, pain, blurred vision, haloes around lights

26
Q

how is intra occular pressure measured?

what is normal range?

A

tonometry

10-21mmHg

27
Q

signs of raised IOP on fundoscopy

A

optic disc cupping - indent in the middle of optic disc, should be less than half the size of the disc. Cup - disc ratio >0.7 = abnormal

optic disc colour- pale = optic atrophy

28
Q

1st line treatment of open angle glaucoma

A

latanoprost (prostaglandin analogue)

29
Q

how does latanoprost work

A

increaeses uveoscleral outflow

30
Q

side effects of latanoprost

A

eyelash growth

eye lid pigmentation

browning of iris

31
Q

2nd line treatment options of open angle glaucoma

A

beta blockers (timolol) - decrease aqueous humour production

carbonic anydrase inhibitors (dorzolamide) - decrease aqueous humour production

miotics (pilocarpine)- increase uveoscleral outflow

32
Q

treatment of open angle glaucoma if topical therapy ineffective

A

trabelectomy surgery

33
Q

what is retinitis pigmentosa

A

inherited condition where there is degeneration of rods + cones in the retina

34
Q

symptoms of retinitis pigmentosa

A

night blindness- often first symptom

peripheral vision lost first, before central vision

  • tunnel vision
35
Q

signs of retinitis pigmentosa on fundoscopy

A

black bone spiculae pigmentation on peripheral retina

36
Q

what is Usher’s syndrome

A

retinitis pigmentosa + hearing loss

Year 4: Opthalmology (8 decks)

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