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Ophthamology > Loss of vision > Flashcards

Loss of vision Flashcards

1
Q

what are the 5 causes of sudden vision loss?

A 
vascular cause
vitreous haemorrhage
retinal detachment
WET ARMD
closed-angle glaucoma
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2
Q

What are the causes of central retinal artery occlusion?

A

GCA
embolic
carotid artery disease

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3
Q

What are the signs of a central retinal artery occlusion?

A

RAPD

loss of red reflex

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4
Q

What is seen on fundoscopy in central retinal artery occlusion?

A

pale swollen retina
thin and narrow vessels
cherry red spot at macula

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5
Q

treatment for central retinal artery occlusion…

A

only effective within 12-24hrs
ocular massage
IV Diamox
anterior chamber paracentesis

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6
Q

What can cause central retinal vein occlusion?

A

Virchow’s triad

raised IOP

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7
Q

What are the signs of central retinal vein occlusion?

A

sudden painless visual loss

RAPD

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8
Q

What is seen on fundoscopy in central retinal vein occlusion?

A 
red oedematous retina
dilated vessels
cotton wool spots
retinal flame haemorrhages
neovascularisation (if long-standing)
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9
Q

treatment for central retinal vein occlusion…

A

no ischaemia - observe in 3 months
ischaemia but no neovascularisation - observe in 4-6 wks
ischaemia and neovascularisation - urgent anti-VEGF

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10
Q

what is a vitreous haemorrhage?

A

haemorrhage into vitreous cavity

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11
Q

what can cause a vitreous haemorrhage?

A

abnormal vessels - DM

normal vessels - retinal tear

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12
Q

symptoms and signs of vitreous haemorrhage…

A

loss of vision
floaters
loss of red reflex
haemorrhage on fundoscopy

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13
Q

treatment for vitreous haemorrhage…

A

identify cause

virectomy if non-resolving

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14
Q

What is a retinal detachment?

A

separation of vitreous gel from retina

leads to retinal tear and then detachment

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15
Q

symptoms and signs of a retinal detachment…

A

painless loss of vision
flashing lights and floaters
dark shadow in peripheral vision
RAPD

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16
Q

Treatment for retinal tear…

A

laser of tear to prevent detachment

if retina detached - surgery

17
Q

what is wet age-related macular degeneration (ARMD)?

A

abnormal, new vessel growth that can haemorrhage and leak into macula area

18
Q

symptoms and signs of wet ARMD…

A

sudden central vision loss

metamorphopsia

19
Q

what is seen on fundoscopy in wet ARMD?

A

red pool of blood

pale grey oedematous macula

20
Q

tx for wet ARMD…

A

anti-VEGF intra vitreal injection

21
Q

What are the causes of gradual vision loss?

A 
Cataract
ARMD (dry)
Refractive error
Diabetic retinopathy
Inherited disorders
Glaucoma (open-angle)
22
Q

what is a cataract?

A

opacification of crystalline lens

23
Q

symptoms and signs of cataracts?

A

gradual painless vision loss
haloes flares
loss of red reflex
white pupil

24
Q

tx for cataracts…

A

surgery

25
Q

what is the commonest cause of blindness?

A

dry ARMD

26
Q

what causes dry ARMD?

A

wear and tear of retinal pigment epithelium

27
Q

symptoms and signs of dry ARMD…

A

drusen deposition around macula

gradual central vision loss

28
Q

treatment for dry ARMD…

A

no active tx
visual aids
blind registration

29
Q

What happens in diabetic retinopathy?

A

damage to blood-retina barrier causing occlusion of blood vessels and leakage into retinal circulation and neovascularisation

30
Q

what investigation is done in diabetic retinopathy?

A

fundoscopy

31
Q

treatment for diabetic retinopathy…

A

glycaemic control
laser photocoagulation
anti-VEGF, focal laser

32
Q

what is the second most common cause of blindness?

A

open angle glaucoma

33
Q

what is an open angle glaucoma?

A

iridocorneal angle is open but there is no obstruction

dysfunction in outflow of aqueous humour

34
Q

symptoms of open angle glaucoma…

A

asymptomatic
slow painless vision loss
untreated- peripheral then central vision loss

35
Q

what are 2 diagnostic signs for open angle glaucoma?

A

raised IOP

optic disc cupping

36
Q

Tx for open angle glaucoma…

A 
prostaglandins
beta-blockers
sympathomimemtics
carbonic anhydrase inhibitors
pilocarpine
surgery - trabeculectomy

Ophthamology (3 decks)

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