Ocular emergencies Flashcards
What are the symptoms of central retinal artery occlusion?
- Sudden, painless loss of vision
- Perception of light
- Pupil non-reactive to light
How do you diagnose central retinal artery occlusion?
- Pale retina with cherry red spot
* RAPD
What are the risk factors for central retinal artery occlusion?
- HTN
- Hypercholesterolaemia
- DM
- Obesity
- Vascular Hx
What important medical emergency must be excluded in someone presenting with central retinal artery occlusion in an older patient?
Giant cell arteritis or polymyalgia rheumatica
What happens in retinal detachment?
Retina separates from the choroid
A retinal tear allows vitreous fluid to get between the retina and choroid
What are the symptoms of retinal detachment?
- Painless sudden loss of vision
- Dense shadow that starts peripherally and progresses towards central vision
- Vein/curtain over field of vision
What are the risk factors for retinal detachment?
- Myopia (larger eyeball = thinner at periphery)
- Trauma
- Older age
- Family Hx
- Diabetic retinopathy
How do you diagnose a retinal detachment?
Dilated fundal examination
• Asymmetric red reflex
• Detached retinal folds
Snellen
• Visual acuity may be reduced if the macula is involved
Swinging light test
• RAPD if extensive detachment
What are the symptoms of orbital cellulitis?
- Periocular erythema
- Periocular swelling/proptosis
- Chemosis (red and swollen conjunctiva)
- Reduced vision
- Reduced and painful eye movements
- Systematically unwell
- Pyrexia
What are the common causative pathogens of orbital cellulitis and where do they arise from?
- Haemophilus influenzae
- Staphylococcus aureus
- Streptococcus pneumoniae
- Betahaemolytic streptococcus
Adjacent ethmoid sinus
What is endophthalmitis?
Infection of the anterior and/or posterior chambers of the eye
What are the symptoms of endophthalmitis?
- Reduced vision
- Red eye
- Pain
How do you diagnose endopthalmitis?
• White fluid level in anterior chamber – hypopyon
