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Year 4: Opthalmology > Sudden Vision Loss > Flashcards

Sudden Vision Loss Flashcards

1
Q

pneumonic for causes of sudden loss of vision

A

VARICOSE

Vascular occlusion / vitreous haemorrhage

Age related macular degeneration

Retinal detachment

Ischaemic optic neuropathy

Closed angle glaucoma

Optic neuritis

Stroke

Emergency refferal

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2
Q

types of vascular occlusion

A

central retinal artery occlusion

central retinal vein occlusion

amaurosis fugax

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3
Q

causes of central retinal artery occlusion

A

atherosclerosis

giant cell arteritis

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4
Q

presentation of central retinal artery occlusion

A

painless vision loss

RAPD

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5
Q

what is a RAPD

A

relative afferent pupillary defect

  • pupil in the affected eye constricts more when light is shone in the other eye compared to when it is shone in the affected eye itself
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6
Q

appearance of central retinal artery occlusion on fundoscopy

A

pale retina with cherry red spot

thread like vessels

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7
Q

management of central retinal artery occlusion presenting within 24 hours

A

occular massage

  • trying to move occlusion from central artery to a branch artery
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8
Q

investigations for cause of central retinal artery occlusion

A

carotid doppler – atherosclerosis

ESR + temporal biopsy – giant cell arteritis

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9
Q

what causes a central retinal vein occlusion?

what are the risk factors

A

thrombus formation in the retinal vein

HTN

high cholesterol

diabetes

smoking

glaucoma

SLE

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10
Q

appearance of central retinal vein occlusion on fundoscopy

A

retinal haemorrhages

optic disc + macula oedema

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11
Q

treatment options for central retinal vein occlusion

A

aim to prevent macula oedema and neovascularisation

  • laser photocoagulation
  • intravitreal steroids
  • anti-VEGF
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12
Q

what is amaurosis fugax

A

transient central retinal artery occlusion

temporary painless loss of vision - ‘like a curtain coming down’

may indicate TIA- prescribe 300mg aspirin

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13
Q

what is wet age related macula degeneration

A

development of new vessels in choroid layer of retina

vessels leak causing fluid build up, vision loss and eventual scarring

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14
Q

symptoms of wet ARMD

A

loss / blurring of central vision

distorted vision - straight lines look wavy

floaters

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15
Q

treatment of wet ARMD

A

anti-VEGF

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16
Q

what is a retinal detachment

A

retina separates from choroid underneath

  • allows vitreous fluid to get under retina and fill space underneath
17
Q

risk factors for retinal detachment

A

trauma

previous detachment

myopia

marfans syndrome

18
Q

symptoms of retinal detachment

A

painless sudden peripheral vision loss - like a shadow coming across vision

flashes + floaters

19
Q

treatment of retinal detachment

A

surgical repair

20
Q

what is ischaemic optic neuropathy

A

infarction of optic nerve head due to obstruction of posterior ciliary arteries

21
Q

causes of ischaemic optic neuropathy

A

arteritic - Giant cell arteritis

non-arteritic - atherosclerosis

22
Q

what causes acute closed angle glaucoma

A

raised intra-ocular pressure secondary to impaired aqueous outflow

23
Q

normal pressure range in the eye

A

10-21 mmHg

24
Q

risk factors for acute closed angle glaucoma

A

increasing age

hypermetropia (long sighted)

female

asian ethnicity

25
Q

symptoms of acute closed angle glaucoma

A

severely painful red eye

haloes around lights

nausea + vomiting

  • symptoms worse watching tv in a dark room
26
Q

appearance of the pupil in acute closed angle glaucoma

A

fixed mid dilated pupil

27
Q

signs of acute closed angle glaucoma on examination

A

fixed mid dilated pupil

no pupillary light response

decreased visual acuity

red hard eye

clouding of cornea

28
Q

treatment of acute closedangle glaucoma

A

topical pilocarpine – constricts pupil to open the angle

oral acetezolamide - decreases aqeuous humour production

29
Q

what may be required as a definitive treatment of closed angle glaucoma

A

laser iridotomy

  • makes hole in iris to allow aqueous humour to flow from posterior chamber into anterior chamber
30
Q

what is optic neuritis

A

inflammation of the optic nerve

31
Q

what conditions can cause optic neuritis

A

MS

Diabetes

Sarcoidosis

Syphilis

32
Q

symptoms of optic neuritis

A

pain worse on eye movement

impaired colour vision

unilateral decrease in visual acuity

33
Q

treatment of optic neuritis

A

methylprednisolone

  • recovery takes 4-6 weeks
34
Q

who is vitreous haemorrhage most common in

A

diabetics

35
Q

symptoms of vitreous haemorrhage

A

sudden painless vision loss

red hue in vision

floaters

Year 4: Opthalmology (8 decks)

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