Sudden Loss of Vision

Question 1

What are the ischaemic/vascular changes that could occur?

Answer 1

‘Amaurosis fugax’. ‘Curtain coming down’
Can represent a TIA. Give aspirin 300mg.

Ischaemic optic neuropathy is due to occlusion of the short posterior ciliary arteries

Question 2

What happens in central retinal vein occlusion?

Answer 2

Glaucoma, polcythaemia and HTN cause this

Severe retinal vein haemorrhages are seen on fundoscopy

Question 3

What happens in central retinal artery occlusion?

Answer 3

Due to thromboembolism or arteritis

Looks like a cherry red spot

Question 4

What are the features of retinal detachment?

Answer 4

Dense shadow that starts peripherally and progresses towards the centre of vision
A veil or curtain over the field of vision
Straight lines appear crooked
Central vision loss

Question 5

What are the features of posterior vitreous detachment?

Answer 5

Flashes of light in the peripheral field of vision

Floaters

Question 6

What are the features of optic neuritis?

Answer 6

'CRAP'
Central scotoma
Rapid
Acuity decreased
Pain worse on movements