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…

25
what is the commonest cause of blindness?
dry ARMD
26
what causes dry ARMD?
wear and tear of retinal pigment epithelium
27
symptoms and signs of dry ARMD...
drusen deposition around macula | gradual central vision loss
28
treatment for dry ARMD...
no active tx visual aids blind registration
29
What happens in diabetic retinopathy?
damage to blood-retina barrier causing occlusion of blood vessels and leakage into retinal circulation and neovascularisation
30
what investigation is done in diabetic retinopathy?
fundoscopy
31
treatment for diabetic retinopathy...
glycaemic control laser photocoagulation anti-VEGF, focal laser
32
what is the second most common cause of blindness?
open angle glaucoma
33
what is an open angle glaucoma?
iridocorneal angle is open but there is no obstruction | dysfunction in outflow of aqueous humour
34
symptoms of open angle glaucoma...
asymptomatic slow painless vision loss untreated- peripheral then central vision loss
35
what are 2 diagnostic signs for open angle glaucoma?
raised IOP | optic disc cupping
36
Tx for open angle glaucoma...
``` prostaglandins beta-blockers sympathomimemtics carbonic anhydrase inhibitors pilocarpine surgery - trabeculectomy ```