Loss of vision Flashcards
Causes for sudden loss of vision?
- Central retinal artery/vein occlusion
- Anterior ischaemic optic neuropathy
Causes for gradual loss of vision
- Catarract
- Glaucoma
- Age related macular disease
- Diabetic retinopathy
Causes for central retinal artery occlusion
- Emboli
- Inflammation
Causes for central retinal vein occlusion
- Hypertension
- Hyperviscosity
- Glaucoma
- Inflammation
Appearance in CRAO
- Pale
- lack of blood vessels
Appearance of CRVO
- Dark
- Tortuous dilated veins
- Macula and optic disc oedema due to build up of blood
Treatment for central retinal occlusion
Intra-vitreal antiveg F
Anterior ischaemic optic neuropathy- which arteries are involved
short posterior ciliary arteries
Which are the two types of anterior ischaemic neuropathy
Artheritic
Non-artheritic
Symptoms/Signs of artheritic AION
Symptoms
- Loss of vision
- Headaches
- Loss of appetite
- Scalp tenderness
- Pain when chewing : due to ishchaemic masseter (innervated by same blood vessels)
Signs
- Tenderness on superficial temporal arteries
- Raised inflammatory markers
Investigation and treatment of AION
Investigation
- Raised CRP
- Raised ESR- inflammatory markers
Management:
High dose steroids
Catarract pathology
Opacification of the Lens
When light comes into the eye it can no longer be broken down
Management of cataract
Surgery : commonest surgery in the UK as an age related issue and as we all know there is an ageing population
Local anaestetic
Incision into lens
Phacoemulsification: breaks down the lens
Lens resected and clear capsular bag is inserted instead
Age related macula damage two types?
Wet
Dry
Signs of age related macula disease
- Distorted ambler chart
- Drusen: yellow droplets under the retina made up of fat
- Pigment epithelium changes in macula
Properties of dry Macula degeneration
- Atrophy: loss of central vision
- Macula become stained with these druse
- Treat with vision aids
Properties of wet macula degeneration
- Formation of new blood vessels which grow towards the macula
- They are weak and therefore they burst easily leading to the macula being impaired
- Investigate with OCT and fluorescing angiography
- Manegement: intravitreal antivegf , Low vision aid, registration
Signs of diabetic retinopathy
- Microaneurysms (swelling on capillaries)
- Retinal hemorrages and exudates
- Neovascularisation on the disc or the retina
Investigations of diabetic retinopathy
- OCT
- Flurescin angiography
Management of diabetic retinopathy
- Intravitreal antivegf
- laser
- low vision aids
- registration
