Retina and Optic Nerve Flashcards
What is Optic Neuritis?
What is another concern for this condition?
Inflammatory demyelinating condition of the Optic nerve.
Can be linked to MS since it is a demyelination disease
Clinical presentations of Optic Neurits
Acute onset of condition (hrs - days)
Monocular vision loss
Painful EOMs
Central scotoma “blurry central vision”
Symptoms of Optic Neuritis
Loss of visual acuity
Color vision loss
- Relative Afferent Pupillary Defect
- Pupill is unable to stay constricted during swinging light test
How is the Optic nerve affected during Optic neuritis
Swollen, pallor optic nerve
Flame shaped, peri-papillary hemorrhages
How is a Optic neuritis diagnosed?
Refer urgently to ophthalmologist
Perform MRI on brain and orbits
How is Optic Neuritis treated?
IV methylprednisolone for 3 days and taper off to allow recovery
What is Papilledema
Swelling of the optic n. due to inter cranial pressure
Ddx or possible signs of a Papilledema
- Tumors
2. Cerebral edema (encephalopathy)
Clinical presentations of Papilledema
- Swollen optic n.
- Margins of disk are obscure/not sharp
- Venules are dilated and twisted
- Cotton wool spots = flame hemorrhages and infarctions
Treatments of Papilledema
Immediate ophthalmologist
What is Age Related Macular Distention
Degenerative loss of the macula (central retina)
Leading cause of adult blindness
What are the 2 types of AMD?
- Dry AMD
- Retinal drusens are yellow deposits
- Retinal pigment endothelium atrophy causing a loss of central vision - Wet AMD
- Growth of new abnormal vessels that leak
- Main cause of blindness in AMD
What are the symptoms and signs of Age Related macular Distention
- Loss of central vision
- Metamorphopsia (wavy vision)
- Central scotoma
- Amsler grid distortion
What happens during a Retinal Detachment
Retina tears and it allows fluid works its way underneath the retina
Symptoms of Retinal Detachment
- Curtain coming down in one eye
- Cloudy vision
- Floaters or flashes of lights
How is a Retinal Detachment clinically presented?
Fundoscopy exam will show a bulging tent like retina
May also see a vitreous hemorrhage
Treatment for Retinal Detachment
Immediate Ophthalmology referral
Have the patient supine and turn head towards effected eye to allow retina to fall back in place
How is Amaurosis Fugax presented?
- Fleeting blindness
- Episodes of curtain falling causing temporary blindness lasting for a few minutes
What is the cause of Amaurosis Fugax and how is it treated?
Cause: retinal emboli potentially from carotid disease
Treatment: Depends on cause
Perform an ultrasound or Magnetic Resonance Angiography (MRA)
EKG to find heart abnormality
What are the classic findings of a Central Renal Artery occlusion?
- Painless, loss of vision
- Cherry red spot (cherry red spot”
Treatment for Central Retinal Artery Occlusion
Ophthalmology referral immediately
What are classical findings for Central Vein Occlusion?
- Blood and thunder fundus
- Venous dilation and tortuosity
- Multiple hemorrhages
Symptoms of Retinal Vein occlusion?
Painless vision lost
Noticed first thing while walking up
How is Central Retinal vein occlusion treated?
Referral to Ophthalmology
Aspirin to help with occlusion
If young pt evaluate for HTN and hyper coagulability
