Loss of Vision Flashcards
What should be asked in the history for vision loss?
Unilateral/bilateral
Onset - sudden/gradual (over what period of time)
Type of visual loss - blurred/distorted/black
Any associated symptoms (such as pain, redness, discharge)
What examinations are done for vision loss?
Best corrected visual acuity
Snellen chart
Fundal examination (direct opthalmoscope slit lamp and volk lens)
Ancilary tests (amsler chart, colour vision, visual field assessment, flurescein angiography, optical coherence tomography)
What are the different categories of vision loss?
Sudden complete loss of vision (vascular)
Gradual loss of vision
What are examples of sudden complete loss of vision (vascular)?
Central retinal artery occlusion
Central retinal vein occlusion
Anterior ischaemic optic neuropathy
What are examples of conditions that cause gradual loss of vision?
Cataract
Glaucoma
Age related macular degeneration
Diabetic retinopathy
What is the management of central retinal artery occlusion?
Identify and treat risk factors
What is the management of central retinal vein occlusion?
Identify and treat risk factors
Intravitral anti Vegf
What are different kinds of anterior ischaemic optic neuropathy?
Arteritic (gian cell arteritic)
Non arteritic
What are symptoms of anterior ischaemic optic neuropathy?
Loss of vision
Headache
Loss of appetite
Scalp tenderness
Pain on chewing
What are signs of arteritic anterior ischaemic optic neuropathy?
Tenderness of superficial temporal arteries
Raised inflammatory markers
What is the management of anterior ischaemic optic neuropathy?
High dose systemic steroids
What is the management of non-arteritic anterior ischaemic optic neuropathy?
Identify and treat risk factors
What are signs of non-arteritic anterior ischaemic optic neuropathy?
None really, it is painless
What is cataract?
Gradual opacification of the lens
What are symptoms of cataract?
Loss of vision
Dazzle/glare
What is the management of cataract?
Surgery (phacoemulsification with intraocular lens implant)
What is Glaucoma?
Optic neuropathy with typical optic nerve damage and associated visual field changes usually associated with raised intraocular pressure
How can different glaucomas be classified?
Open or closed angle
Chronic or acute
What are symptoms of glaucoma?
Asymptomatic
Gradual loss of peripheral field of vision
What are signs for chronic glaucoma?
Raised intraocular pressure
Visual field defects
What is the management for chronic glaucoma?
Topical treatment
Surgery (trabeculetomy)
What is a trabeculetomy?
Surgical procedure that lowers the intraocular pressure inside the eye
What is age related macular degeneration?
Small central portion of the retina, the macula, wears down
What does AMD stand for?
Age related macular degeneration
What are the different kinds of age related macular degeneration (AMD)?
Dry AMD (90%)
Wet (neovascular) AMD (10%)
What are symptoms of age related macular degeneration (AMD)?
Progressive loss of central vision
Distorsion
What are signs of age related macular degeneration (AMD)?
Distortion on amsler chart
Drusen
Pigment epithelial changes
What are symptoms of dry AMD?
Drusen
Atrophy
What does atrophy mean?
Wasting away
What is drusen?
Yellow deposits under the retina
What is the management of dry AMD?
Low vision aids
Registration
What are symptoms of wet AMD?
Choroidal new vessels
What are investigations of wet AMD?
OCT
Flurescein angiography
What is the management of wet AMD?
Intravitral antivegf
Low vision aids
Registration
What is diabetic retinopathy?
Complication of diabetes caused by high blood sugar levels damaging the retina
What is the commonest cause of visual impairment in the working age population?
Diabetic retinopathy
What are signs of diabetic retinopathy?
Microaneurysms
Retinal haemorrhages and exudates
Neovascularisation (disc/retina)
What investigations are done for diabetic retinopathy?
Flurescein angiography
Optical coherence tomography (OCT)
What is the mangement of diabetic retinopathy?
Intravitreal antivegf
Laser (panretinal photocoagulation)
Low vision aids
Registration
