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Opthalmology > Painless loss of vision > Flashcards

Painless loss of vision Flashcards

1
Q

What things can cause acute loss of vision?

A

Vascular events

  • Systemic - stroke/TIA
  • Eye - retinal vessel occlusion, ischaemic optic neuropathy

Retinal + vitreous

  • Haemorrhage
  • Retinal detachment
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2
Q

What things can cause chronic loss of vision?

A

Neurological

  • Tumours compressing along optic n pathway

Ophthalmic

  • Corneal dystrophies
  • Cataract
  • Glaucoma
  • Diabetic retinopathy/maculopathy
  • ARMD
  • Uveitis
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3
Q

How does amaurosis fugax/TIA present?

A

Transient loss of vision, usually recovers within 1h

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4
Q

How should you assess someone with amaurosis fugax?

A

Assess CV risk factors, BP

Fundoscopy - check for retinal emboli

Asculutate for carotid bruits/heart murmurs

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5
Q

What tends to cause central retinal artery occlusion?

A

Usually embolic from carotids/heart

Rarely inflammatory, e.g. GCA, severe retinal vasculitis

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6
Q

What are the two types of anterior ischaemic optic neuropathy?

A

Arteritic and non-arteritic cause

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7
Q

What are the symptoms of AION?

A

Rapid onset blurred vision
Classically altitudinal

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8
Q

What are RFs for AION?

A

CV risk factors

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9
Q

What must you exclude as a cause of AION?

A

GCA (unilateral headache, jaw claudication, ESR, CRP, FBC)

Use temporal artery biopsy

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10
Q

What are risk factors for central retinal vein occlusion?

A

Age, HTN, glaucoma, DM

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11
Q

What are common causes of vitreous haemorrhage?

A

Proliferative DR

Retinal tears

Disciform macular degeneration

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12
Q

What are common risk factors for retinal detachment?

A

Myopia

Trauma

Family history
Cataract surgery

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13
Q

What are rarer causes for retinal detachment?

A

Intraocular tumours

Intraocular inflammation

Vitreal degeneration

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14
Q

What are common causes of cataracts?

A

Advanced age

Smoking

Ocular trauma

Prev. intraocular surgery
Congenital

Assoc with systemic dontions

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15
Q

What are symptoms of cataracts?

A

Reduced visual acuity - hazy, foggy, cloudy

Glare

Myopic shift (becoming more short sighted)

Monocular diplopia

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16
Q

How are cataracts managed?

A

Phacoemulsification + intraocular lens implantation

17
Q

What generally causes this pattern of visual loss?

A

Open angle glaucoma

18
Q

What is the visual loss like in ARMD?

A

Painless progressive loss of central vision

Metamorphopsia (distortion) + scotoma

19
Q

What are risk factors for ARMD?

A

Age

Smoking
Poor diet and lack of greens

20
Q

What does dry ARMD look like on fundoscopy?

A

Drunsen deposits

Areas of atrophy

21
Q
A

Drusen

22
Q

What occurs in wet ARMD?

A

Choroidal neovascular membrane leaks fluid/blood in or under retina detaching photoreceptors

23
Q

How is dry ARMD managed?

A

Specific multivitamins

Supportive measures

24
Q

How is wet ARMD managed?

A

Intra-vitreal anti-VEGF

25
Q

What are risk factors for diabetic retinopathy?

A

Duration of diabetes

Poor metabolic control

Pregnancy

26
Q

What are signs of diabetic retinopathy?

A

Microaneurysms, retinal haemorrhages, exudates, macular oedema, cotton wool spots, intraretinal microvascular abnormality, abnormal new vessel growth

27
Q
A

Cotton wool spots

28
Q

What is the classification of diabetic retinopathy/

A

Background diabetic retinopathy - dot and blot haemorrhages

Pre-proliferative - cotton wool spots, IRMA

Proliferative - new vessels, tractional RD

Diabetic macular oedema - exudates, haemorrhage, retinal thickening

29
Q
A

Non-proliferative diabetic retinopathy

30
Q

How do you manage diabetic retinopathy?

A

Control blood sugar, BP, cholesterol

Laser

Surgery in severe cases

Intravitreal anti-VEGF, steroid

31
Q
A

Diabetic maculopathy

Top left: early

Bottom left: focal

Top right: diffuse

Bottom right: macular grid

32
Q
A

Hypertensive retinopathy

Far right is malignant hypertension

33
Q

What signs do you see in thyroid eye disease?

A

Lid retraction, proptosis, corneal exposure, reduced ocular movement, diplopia, optic nerve compression

34
Q

What are the types of uveitis?

A

Anterior

Intermediate - vitreous and ciliary body

Posterior - retina: retinitis; choroid: choroiditis; BVs: vasculitis

Panuveitis

35
Q

What are causes of uveitis?

A

Idiopathic

Systemic dx - sarcoidosis, Wegner’s, AS, Behcets, SLE
Infection - TB, syphillis, toxoplasmosis, HSV, Lyme, CMV

Masquerade - intraocular lymphoma, leukaemia

36
Q

How is uveitis treated?

A

If infective - find agent, treat accordingly

Idiopathic/assoc. w. systemic dx - anti-inflammatories + immunosupression

37
Q

What are some anterior segment sequelae of anterior uveitis?

A

Opthalmology (6 decks)

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