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Year 2- CNS > Loss of Vision > Flashcards

Loss of Vision Flashcards

1
Q

What would you ask when taking a history of someone with vision loss?

A

Unilateral/bilateral
Gradual/sudden
Blurred/distorted/black
Associated symptoms e.g. pain, redness, discharge

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2
Q

Which examination would be carried out in loss of vision cases?

A

Fundal examination- direct ophthalmoscope slit lamp and volk lens

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3
Q

Which ancilliary tests are used to diagnose and monitor eye conditions?

A

Amsler Chart
Colour vision chart
Visual Filed Assessment
Fluorescein Angioplasty
Optic Cohernece Tomography

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4
Q

Which chart is useful in assessing function of the optic nerve?

A

Colour Vision Chart

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5
Q

Which chart is useful for detecting colour blindness?

A

Colour Vision Chart

->especially good for red-green colour blindness

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6
Q

Is optical coherence tomography invasive or non-invasive?

A

Non-invasive

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7
Q

What is the most likely vascular cause of sudden complete loss of vision?

A

Central Retinal Artery Occlusion

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8
Q

When you examine a patient with central retinal artery occlusion using fundus imaging, what would be seen?

A

A pale retina with a cherry red spot

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9
Q

In patients with central retinal artery occlusion, which specialists need to be contacted?

A

Stroke team

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10
Q

What will need to checked in patient’s with central retinol artery occlusion?

A

BP
Pulse

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11
Q

What is the treatment for central retinal artery occlusion?

A

Identify and treat cardiovascular risk factors

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12
Q

Which drug will you often start a patient with central retinol artery occlusion on?

A

Aspirin

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13
Q

What is the treatment of a branch retinal artery occlusion, in which there is an arterial occlusion to a particular branch of vessels?

A

Identify and treat cardiovascular risk factors

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14
Q

Central retinal vein occlusion is another cause of sudden complete loss of vision.
How is this managed?

A

Identify and treat CV risk factors.

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15
Q

What may patients with central retinal vein occlusion develop?

A

Macular oedema

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16
Q

If a patient develops macular oedema, which treatment is given to reduce this fluid?

A

Intravitreal Anti Vegf

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17
Q

Anterior ischaemic optic neuropathy can also cause sudden complete loss of vision.
Which two divisions of AION are there?

A

Arteritic (Giant Cell Arteritis)
Non-arteritic

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18
Q

What are some of the symptoms of Giant Cell Arteritis?

A

Loss of vision
Unilateral temporal headache
Loss of appetite- weight loss
Scalp tenderness
Jaw claudication

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19
Q

What are some of the signs of Giant Cell Arteritis?

A

Tenderness of superficial temporal arteries
Raised inflammatory markers
Raised platelets

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20
Q

Which inflammatory markers would be raised in patient’s with Giant Cell Arteritis?

A

ESR
CRP

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21
Q

What is the management for Giant Cell Arteritis?

A

High dose systemic steroids

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22
Q

How will non-arteritic anterior ischaemic optic neuropathy patient’s present?

A

Half their vision completely missing, no pain

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23
Q

What is the treatment for non-arteritic anterior ischaemic optic neuropathy ?

A

Identify and treat CV risk factors

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24
Q

If you suspect non-arteritic anterior ischaemic optic neuropathy, what must you rule out first?

A

Giant Cell Arteritis

This can be done by checking inflammatory markers

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25
Q

What happens if Giant Cell Arteritis is not diagnosed?

A

Loss of vision in both eyes, even if one does not appear to be affected

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26
Q

Describe the speed of vision loss of vitreous haemorrhage.

A

Rapid but not sudden

27
Q

What can cause Vitreous Haemorrhage?

A

Trauma
Posterior vitreous detachment
Proliferative diabetic retinopathy

28
Q

What are some risk factors for retinal detcahment?

A

Myopia
Trauma
Cataract surgery

29
Q

What will most patients with retinal detachment experience?

A

Flashing lights and floating spots in their vision.

30
Q

What is the management for retinal detachment?

A

Surgical repair

31
Q

If a patient is caught early and has a retinal tear rather than a retinal detachment, and the fluid has not seeped to behind the retina, what can the management be?

A

Laser retinal plexi

32
Q

What are some common causes of gradual loss of vision?

A

Cataract
Glaucoma
Age related macular degeneration
Diabetic retinopathy

33
Q

What is the most common cause of loss of vision in the world?

A

Cataracts

34
Q

What are the symptoms of cataracts?

A

Loss of vision
Dazzle/glare

35
Q

When are symptoms of cataracts particularly noticeable?

A

At night/evening

36
Q

What is the management of cataracts?

A

Surgery- phacoemulsification with intraocular lens implant

37
Q

What is glaucoma?

A

Optic neuropathy with typical optic nerve damage and associated visual field changes.

38
Q

What is glaucoma usually associated with?

A

Raised IOP

39
Q

What are the classifications of glaucoma?

A

Open or closed angle
Chronic or acute

40
Q

What are the symptoms of glaucoma?

A

Asymptomatic to start with
Gradual loss of peripheral field vision.

41
Q

Patients at a higher risk of developing glaucoma get checked to try and catch it before it develops.
What is done to try and diagnose glaucoma?

A

Check IOP
Fundoscopy
Visual field test

42
Q

What are to signs indicative of glaucoma?

A

Raised IOP
Visual field defects
Optic disc damage

43
Q

What is the gold standard for measuring eye pressure?

A

Goldmanm Tonometer

44
Q

What is the initial management for glaucoma?

A

Topical treatment

45
Q

What is the secondary management for glaucoma?

A

Surgery

e.g. trabeculectomy, drainage

46
Q

Which topical treatments may be given as the initial management for glaucoma?

A

Prostaglandins
Beta blockers
Carbonic anhydrase inhibitors

47
Q

What is the most common cause of severe permanent visual loss and people over the age of 60?

A

Age related macular degeneration (AMD)

48
Q

What are the symptoms of AMD?

A

Progressive loss of central vision
Distortion

49
Q

What might be seen on fundoscopy in someone with AMD?

A

Yellow patches at the macula- called reasons.
They are calcium and protein salt deposits.

50
Q

Which chart can be used to assess distortion?

A

Amsler chart

51
Q

AMD can be classified as wet or dry. Which type is more common?

A

Dry AMD

52
Q

What is the treatment for dry AMD?

A

No treatment, mainly supportive in form of low vision aids and registration for sight impairment/severe sight impairment

53
Q

Which investigations can be done in those with wet AMD?

A

OCT- Optical CT
Fluorescein angiography

54
Q

Can dry AMD progress into wet AMD or does wet AMD progress into dry AMD?

A

Dry AMD can turn into wet AMD.

55
Q

Why type of AMD involves abnormal blood vessels?

A

Wet AMD

56
Q

What is the management for wet AMD?

A

Intravitreal antivegf
Low vision aids
Registration with sight impairment/severe sight impairment

57
Q

What might be seen on fundoscopy of someone with diabetic retinopathy?

A

Micro-aneurysms
Retinal haemorrhages
Exudate

58
Q

When may those with diabetes get diabetic retinopathy?

A

If their diabetes is poorly managed or they have a risk factor e.g. pregnancy

59
Q

What happens in proliferative diabetic retinopathy?

A

New vessels or neovascularization on the retina

60
Q

Which investigation is particularly useful in patients with diabetic retinopathy?

A

Fluorescein angiography

61
Q

What is the management of diabetic retinopathy?

A

-Control of diabetes
-Control of BP, BM and cholesterol
-Intravitreal antivegf
-Laser- PRP
-Low vision aids
-Registration for sight/severe sight impairment

62
Q

What is the most common treatment for diabetic retinopathy?

A

Laser- panretinal photocoagulation (PRP)

63
Q

What can happen if diabetic retinopathy is not managed?

A

Could lead to fractional retinal detachment leading to sight loss

64
Q
A

Year 2- CNS (49 decks)

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