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Ophthalmology > Gradual Visual Loss > Flashcards

Gradual Visual Loss Flashcards

1
Q

how does dry ARMD present

A

gradual vision loss
bilateral central vision loss with maintenance of peripheral vision
o/e atrophic macula

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2
Q

can dry ARMD be treated

A

no treatment only prevention helps

visual aids and register as blind

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3
Q

what is a cataract

A

opacification of the lens

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4
Q

state the causes of cataract

A

congenital - must be treated within 4 weeks of birth
age
metabolic - diabetes and hypertension
smoking and alcohol

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5
Q

describe the vision loss seen in cataract

A

gradual vision loss - difficulty reading signs and recognising faces

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6
Q

what is seen with a cataract on examination

A

loss of red reflex

opaque lens

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7
Q

how is cataract treated

A

phaecoemulsification + intraocular lens implant

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8
Q

what are the complications of cataract surgery

A

glaucoma
anterior uveitis
retinal detachment
endophthalmitis

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9
Q

what is glaucoma

A

group of disorders leading to progressive optic nerve damage and visual loss
raised IOP is a feature but not diagnostic

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10
Q

list the triad of changes that occur in glaucoma

A

visual field defect
raised IOP
optic disc cupping

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11
Q

how does raised IOP arise

A

backflow of aqueous humour in the anterior chamber of the eye damaging retinal fibres in the optic disc

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12
Q

what is the normal range for intraocular pressure

A

10-22mmHg

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13
Q

what are the visual field defects seen in glaucoma

A

defect starts in the periphery causing crescent shape

central vision and acuity is maintained until late stages of disease

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14
Q

what is optic disc cupping

A

optic disc is the pale part of disc where there are no neurones, the optic disc increases in size in glaucoma due to damage of the nerve fibres and the size of the cup increases

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15
Q

what is the normal ratio of the optic disc

A

0.4-0.7

anything >0.7 is suggestive of glaucoma

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16
Q

how does chronic closed angle glaucoma present

A

asymptomatic therefore needs picked up through screening

visual field defect, raised IOP and optic disc cupping are observed

17
Q

what is the outline of management of glaucoma

A

aim to reduce production of aqueous humour or increase the drainage of it

18
Q

what drugs are used to treat glaucoma

A

topical prostaglandins
topical beta-blockers and alpha agonists
carbonic anhydrase inhibitors such as acetazolamide

19
Q

acute angle closure glaucoma is an emergency true/false

A

true

20
Q

what is the pathophysiology of acute angle closure glaucoma

A

rapid build up of IOP, iris is pushed against the trabecular meshwork blocking AH flow out of the anterior chamber

21
Q

how does acute glaucoma present

A

sudden painful vision loss
blurred vision
haloes around light
headache, nausea and vomiting

22
Q

what are the examination findings of acute glaucoma

A

hazy cornea
hard tense eye
fix mid-dilated pupil

23
Q

how is glaucoma investigated

A

slit lamp

genioscopy to assess anterior chamber

24
Q

how is acute glaucoma treated

A

IV acetazolamide first line to reduce IOP

trabeculectomy can be carried out once IOP has reduced

25
Q

which factors within diabetes increase risk of developing diabetic retinopathy

A

pregnancy
long duration of disease
poor glycaemic control

26
Q

how does retinopathy develop within diabetes

A

glycosylation of proteins leads to formation of microaneurysms and reduces oxygen transport causing ischaemia
ischaemia congests vessels causing neovascularisation leading to leakage and haemorrhage

27
Q

outline the retinal changes seen in diabetic retinopathy

A

hard exudates - lipoprotein
cotton wool spots
dot blot and flame haemorrhages

28
Q

what is the difference between non-proliferative and proliferative retinopathy

A

non-proliferative does not have neovascularisation of vessels yet, less severe forms

29
Q

what are the features of maculopathy seen in retinopathy

A

macular oedema
blot haemorrhages
hard exudates

30
Q

how is retinopathy managed

A

cannot reverse changes only prevent further damage through tighter glycaemic control

31
Q

outline the stage of retinopathy and the screening time for each

A 
R0 no retinopathy - 12 month
R1 mild - 12 months 
R2 background - 6 months 
R3 referable - refer to oph 
R4 proliferative - refer to oph

Ophthalmology (11 decks)

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