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Neuro > Ophthalmology - Loss of Vision > Flashcards

Ophthalmology - Loss of Vision Flashcards

1
Q

What is used for examination of loss of vision?

A

Best corrected visual acuity
Snellen chart
Fundal exam
Ancillary tests

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2
Q

What does a fundal examination include?

A

Direct ophthalmoscope, slit lamp and volk lens

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3
Q

What are some ancillary tests?

A

Amsler chart
Colour vision
Visual field assessment
Fluorescein angiography
Optical coherence tomography

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4
Q

Describe a asmler chart

A

Usually taken home
Look at central spot one eye at time and see if there is distortion
If changed then alert for eye exam

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5
Q

What does colour vision assess?

A

Optic nerve and red + green colour blindness

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6
Q

Describe fluorescein angiography

A

Retinal conditions and dye injected
Arteries appear white first then after time veins

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7
Q

Describe optical coherence tomography

A

Cross section of retina and good for macula conditions
Can see fovea

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8
Q

Describe central retinal artery occlusion

A

Sudden complete loss of vision due to vascular reasons
Cherry red spot as perfusion of macula by choroidal vessels
Detect CVS risk factors

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9
Q

What is the management for central retinal artery occlusion?

A

CROA
Identify and treat CV risk factors
Aspirin sometimes given

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10
Q

Describe branch retinal artery occlusion

A

Emboli can be seen on fundal exam
Pale artery
Treated same as CROA
Identify and treat CV risk factors

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11
Q

Describe central retinal vein occlusion

A

CRVO - vein drains blood of all of retina
Haemorrhages may be seen and in all 4 quadrants may develop macular oedema

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11
Q

What is the management for central retinal vein occlusion?

A

Identify and treat risk factors
Intravitreal anti Vegf if macular oedema

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12
Q

What are the 2 types of anterior ischaemic optic neuropathy (AION)?

A

Arteritic - giant cell arteritis (optic nerve is pale and borders indistinct)
Non arteritic

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13
Q

What are the signs and symptoms of giant cell arteritis?

A

Loss of vision, unilateral headache, loss of appetite, scalp tenderness and jaw claudication
Tenderness of superficial temporal arteries, raised CRP, ESR and platelets

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14
Q

What is the management of giant cell arteritis?

A

High dose systemic steroids - oral prednisolone

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15
Q

Describe non arteritic anterior ischaemic optic neuropathy?

A

Painless
Half of vision can be missing, disc is swollen, raised CV risks
Management is identify and treat CV risk factors

16
Q

What can cause a vitreous haemorrhage?

A

Posterior vitreous detachment
Proliferative diabetic retinopathy
Trauma
Causes rapid loss of vision

17
Q

What is the management of vitreous haemorrhage?

A

Conservative or vitrectomy - remove VH and blood

18
Q

What are the risk factors for retinal detachment?

A

Myopia, trauma and cataract surgery

19
Q

Describe retinal detachment

A

Have realised flashing lights and floating spots in vision
If caught early with no detachment just tear then managed with laser retinal pelxi
Surgical repair is needed

20
Q

What could cause a gradual loss of vision?

A

Cataract, glaucoma, age related macular degeneration and diabetic retinopathy

21
Q

What are the symptoms of cataracts?

A

Loss of vision and dazzle/gaze especially at night/ evening

22
Q

What is the management for cataracts?

A

Surgery - phacoemulsification with intraocular lens implant

23
Q

What is a glaucoma?

A

Optic neuropathy with typical optic nerve damage and associated field changes usually associated with raised IOP
Open or closed angle and can be chronic or acute

24
Q

What are the symptoms of a glaucoma?

A

Asymptomatic, gradual loss of peripheral field of vision
Presents usually later symptoms

25
Q

What are the signs of chronic glaucoma?

A

Raised IOP, visual field defects and optic nerve damage

26
Q

What is the management for chronic glaucoma?

A

Topical treatment - prostaglandins, BB and carbonic anhydrase inhibitors
Surgery - trabeculectomy and drainage services

27
Q

What are the symptoms of age related macular degeneration?

A

Progressive loss of central vision and distortion
Can be wet or dry (mainly dry)
Wet is more significant

28
Q

What are the signs of age related macular degeneration?

A

Distortion on amsler chart
Drusen - yellow patched on fundoscopy (calcium and protein deposits)
Normal retina and Atrophy in dry

29
Q

What is the management of dry age related macular degeneration?

A

Low vision aids
Registration - sight impaired SSI

30
Q

Describe wet age related macular degeneration

A

Neovascular
Choroidal new vessels
Bleeding out of abnormal vessels at macula

31
Q

What investigations are used for wet age related macular degeneration?

A

OCT - macular oedema may be seen
Fluorescein angiography - hyperfluorescent shows leakages

32
Q

What is the management of wet age related macular degeneration?

A

Intravitreal antivegf
Low vision aids
Registration - SI/SSI

33
Q

What are the signs of diabetic retinopathy?

A

Gradual loss of vision
Microaneurysms
Retinal haemorrhages and exudates
Neovascularisation

34
Q

What are the investigations for diabetic retinopathy?

A

Fluorescein angiography
OCT - macular oedema

35
Q

What is the management of diabetic retinopathy?

A

Control BP, BM and cholesterol
Intravitreal antivegf
Laser - panretinal phtocoagulation
Low vision aids
Registration

Neuro (40 decks)

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