Sudden Visual Loss

Question 1

causes of SVL

Answer 1

AMRD (wet)
Blood (CRVO/CRAO)
Closed angle glaucoma
Detached retina

Question 2

what is ischaemic neuropathy

Answer 2

ischaemia of optic nerve due to posterior ciliary artery occlusion

Question 3

aetiology of ischaemic neuropathy

Answer 3

giant cell arteritis

Question 4

s/s associated to vitreous haemorrhage

Answer 4

loss of vision, floaters

signs- loss of red reflex, may see haemorrhage on fundoscopy

Question 5

2 main causes of vitreous haemorrhage

Answer 5

abnormal vessels, retinal detachment

Question 6

what is age-related macular degeneration

Answer 6

degeneration of macula and accumulation of drusen

Question 7

T/F: ARMD is commonest cause of blindness in UK

Answer 7

T

Question 8

ix for ARMD

Answer 8

amsler grid test, fundoscopy, slit lamp

Question 9

wet ARMD run down

Answer 9

progressive bilateral sudden visual loss, characterised by neovascularisation in choroid (inc leakage of fluid > scarring)

Question 10

s/s of wet ARMD

Answer 10

distorted vision- sctoma and metamorphopsia

Question 11

tx of wet ARMD

Answer 11

anti-VEGF (ranibizumab), monoclonal ABs

Question 12

T/F: dry ARMD causes gradual visual loss

Answer 12

T

Question 13

what is dry ARMD

Answer 13

drusen deposits that accumulate in retina

Question 14

T/F: wet is more common than dry ARMD

Answer 14

F: dry accounts for 90% of cases- mx is low vision aids

Question 15

s/s of dry ARMD

Answer 15

gradual decline of visual acuity, scotoma, visual distortion

signs- druse, atrophic patches of retina

Question 16

which glaucoma causes sudden visual loss

Answer 16

closed angle

Question 17

what is glaucoma

Answer 17

optic nerve damage due to inc IOP due to blockage of acqueous humour drainage

Question 18

open angle glaucoma is…

Answer 18

gradual inc in resistance through trabecular network so aqueous can’t drain, IOP pressure inc > optic nerve damage

Question 19

s/s of open angle glaucoma

Answer 19

gradual vision loss- may have tunnel vision (peripheral vision loss)

Question 20

main ix for IOP

Answer 20

goldmann applantation tonometry

Question 21

myopia (short sighted) is a cause of which glaucoma

Answer 21

open angle

Question 22

mx for open angle

Answer 22

latanoprost- inc uveoscleral outflow

BBs, CAi= reduce aqueous production

Question 23

closed angle glaucoma is…

Answer 23

aqueous humour encounters inc resistance through lens channel as iris bulges forward sealing off the trabecular meshwork > aqueous can’t drain

Question 24

s/s of closed angle glaucoma

Answer 24

acute visual loss, painful red eye, vomiting, firm eyeball

Question 25

tell tale fundscopy sign of closed angle glaucoma

Answer 25

cupping of optic disc on fundoscopy

Question 26

mx of closed angle glaucoma

Answer 26

lower IOP= pilocarpine
CAi= acetazolamide

surgical- laser iridotomy