Sudden Vision Loss, Review

Question 1

Sudden visual loss!

Answer 1

An easy list really as they all need

assessment by a specialist!

Question 2

Retinal Detachment

Answer 2

Retina detaches from underlying suppport tissue
! MEDICAL EMERGENCY
! Permanent damage may occur if detachment is not
repaired in 24-72 hours
Retinal Detachment
 Commonly preceeded by a Posterior
Vitreous Detachment
 Photropsia, flashes of light in peripheral vision
 Sudden dramatic increase in floaters
 Feeling of heavingess in eye

Question 3

Retinal Detachment

Answer 3

Most posterior vitreous detachments do
not progress to retinal detachments,
those that do show:!
 Dense shadow starting peripherally slowly enlarges
toward the central part of vision
 Impression of a veil or curtain was drawn acros the
field of vision
 Straight lines in the world appear as curved
 Central vison loss

Question 4

Optic neuritis


Answer 4

Women > Men, pain on moving the eye, 
central scotoma 
! Loss of central vision with visible 
swelling of optic nerve head on 
opthalmoscopic exam 
! Commonly seen in MS, but is not 
pathoneumonic of MS

Question 5

 Vitreous hemorrhage!

Answer 5

 Aged 50+, flashing lights, floaters
 Floaters, red haze may be present.
Red reflex absent

Question 6

 Age related macular degeneration (ARMD)!

Answer 6

• Loss of central vision d/t damage to the retina at
the macula.!
• Affects older adults >50!
• Dry (non-exudative) form!
• Cellular debris called drusen accumulate
between the retina and choroid, and the retina
can become detached!
• Wet (exudative) form, more severe, blood vessels
grow from the choroid behind the retina, and the
retina can become detached.!
  Either form leads to loss of rods and cones in
macular area, resulting in the loss of central vision.

Question 7

ARMD begins with yellow deposits in the macula called
Drusen build up in Bruch’s membrane
Between the retinal pigmented epithelium and the
underlying choroid.

Answer 7

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Question 8

Age related macular degeneration!

• Rx: OcuDyne II (Allergy Research Group)!

Answer 8

OcuDyne II New and improved 2005 Formula adds natural vitamin E mixed tocopherols high in gamma-tocopheral and tocotrienols, vitamin D, alpha-lipoic acid and lycopene to the formula. With the other vitamins, antioxideants, key amino acids, minerals, bioflavonoids such as quercetin, lutein and zeaxanthin, and extracts of Ginkgo biloba and bilberry, together they support the structural integrity and function of the eye. In particular, lutein is a powerful antioxidant known to be deposited especially in the lens and the macular region of the retine, the area responsible for central vision.

Question 9

 Migraine!

Answer 9

• Ophthalmic migraine !
• Quadrantic vision loss lasting 20-30 minutes, w/
a following HA!

Question 10

 Cerebrovascular disease!

Answer 10

More common elderly,!
•  bilateral vision loss if vertebral artery is involved!
• Univateral vision loss, if carotid artery is involved.

Question 11

 Vascular occlusions!

Answer 11

• Field loss. Diabetes, hypertension!

Question 12

Slow visual loss!

Answer 12

Refer for refractive exam
! Cataracts!
! Corneal opacities