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Ophthalmology > Sudden loss of vision > Flashcards

Sudden loss of vision Flashcards

1
Q

What supplies the inner 2/3rd of the retina

A

central retinal artery

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2
Q

What supplies the outer 1/3rd of the retina

A

choroid

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3
Q

If there is CRAO, what will the patient present with

A

sudden profound vision loss

painless

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4
Q

What will be seen when investigating CRAO

A

relative afferent pupillary defect test +ve (swing test)
pale oedematous retina
thread like vessels

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5
Q

What are the causes of CRAO

A

carotid artery disease

emboli

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6
Q

what is the treatment for CRAO

A

if presents within 24hrs - ocular massage

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7
Q

What is the further management of a patient with CRAO

A

identify cause - carotid doppler

angio

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8
Q

What is another name for transient CRAO

A

amaurosis fugax

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9
Q

What will transient CRAO present with

A

transient sudden loss of vision
like a curtain
resolves within 5min

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10
Q

What is the management for a patient with transient CRAO

A

urgent referral to stroke clinic

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11
Q

CRVO will present as

A

sudden vision loss

mod-severe vision loss (6/9)

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12
Q

What are the causes of CRVO

A 
atherosclerosis
hypertension 
hyperviscosity 
(VIRCHOW'S TRIAD) 
IOP
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13
Q

What would be seen on fundoscopy of someone with CRVO

A

haemorrhages
dilated tortuous veins
disc and macular swelling

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14
Q

what is the treatment for CRVO

A

Anti-VEGF

address underlying factors

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15
Q

What happens in ischaemic optic neuropathy

A

the posterior ciliary artery becomes occluded causing ischaemia and vision loss

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16
Q

What are the 2 causes of ischaemic optic neuropathy

A

GCA (50%)

non-arteritic

17
Q

what is the investigation for GCA

A

temporal artery biopsy

18
Q

What is the treatment for GCA

A

immediate high dose steroids to prevent loss of vision in other eye

19
Q

Vitreous hameorrhage is caused by

A

retinal ischaemia that causes new abnormal blood vessel growth

20
Q

What is vitreous haemorrhage often seen in

A

CRVO

diabetic retinopathy

21
Q

What will a patient present with in vitreous haemorrhage

A

sudden loss of vision
floaters
painless

22
Q

What might be seen on ophthalmascopy of VH

A

loss of red reflex

haemorrhage

23
Q

What is the most likely diagnosis of someone with no new abnormal vessel growth and haemorrhage

A

retinal tear

24
Q

What is the treatment for vitreous haemorrhage

A

identify underlying cause

vitrectomy for those that don’t resolve

25
Q

What will someone with retinal detachment present with

A

painless sudden loss of vision

flashes and floaters

26
Q

Why do flashes and floaters occur in retinal detachment

A

due to the mechanical separation of the retinal from the sensory pigmented epithelium

27
Q

What will be seen on investigation of a patient with a retinal detachment

A

may have RAPD

detachment seen on fundoscopy

28
Q

What is the treatment for retinal detachment

A

surgical repair

29
Q

wet age related macular degeneration will present with

A

sudden loss of vision
central vision loss
distortion of vision (metamorphopsia)

30
Q

what is the most common cause of blindess in patients >65yrs

A

wet ARMD

31
Q

What is the cause of wet ARMD

A

unknown

32
Q

what causes an increased risk of getting wet ARMD

A 
age 
smoking 
diabetes
poor nutrition 
\+ve FHx
33
Q

what is wet ARMD

A

new blood vessels grow from the choroid and leak causing a build up of fluid/blood and eventual scarring

34
Q

What will be seen on investigation of wet ARMD

A

haemorrhage

hard exudates

35
Q

What is the treatment for wet ARMD

A

Anti-VEGF

36
Q

How does closed angle glaucoma occur

A

increased pressure gradient causes the iris to bow forward causing obstruction of the canal of Schlemm and the trabecular meshwork
- causes the aqueous humour to encounter increased resistance which leads to IOP

37
Q

what will someone with closed angle glaucoma present with

A 
pain 
red eye
sudden vision loss
N&V
headache
38
Q

What will be seen on investigation of the eye in closed angle glaucoma

A

corneal clouding (ischaemia)
mild pupil dilatation
circumcorneal injection

39
Q

what is the treatment for acute closed angle glaucoma

A

CA inhibitors/B blockers/ alpha 2 agrenergic agonists/ Parasympathomimetics/prostanoids - to decrease ocular pressure
THEN - laser peripheral iridotomy

Ophthalmology (8 decks)

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