vascular disease of the eye

Question 1

what is retinal artery occlusion

Answer 1

blockage of one of the retinal arteries

Question 2

what is the most common cause of retinal artery occlusion

Answer 2

atherosclerosis-related thrombosis

Question 3

what are the 3 main types of retinal artery occlusion

Answer 3

central artery, branch artery, amaurosis fugax

Question 4

what is amaurosis fugax

Answer 4

transient central retinal artery occlusion

Question 5

how long does amaurosis fugax last

Answer 5

5 mins with full recovery

Question 6

what would a patient describe the vision loss like in amaurosis fugax

Answer 6

like a curtain coming down

Question 7

main symptom of amaurosis fugax

Answer 7

transient, painless visual loss

Question 8

what is seen on fundoscopy of amaurosis fugax

Answer 8

no abnormal signs

Question 9

management of amaurosis fugax

Answer 9

refer to stroke clinic

Question 10

clinical presentation of branch retinal artery occlusion

Answer 10

acute onset of painless monocular visual impairment

Question 11

fundoscopy of branch retinal artery occlusion

Answer 11

absence of perfusion in the affected artery

Question 12

management of branch retinal artery occlusion

Answer 12

refer to stroke clinic

Question 13

what happens as a result of central retinal artery occlusion

Answer 13

infarction of the inner 2/3 of the retina

Question 14

name 3 causes of central retinal artery occlusion

Answer 14

carotid artery disease !!!
emboli from the heart
giant cell arteritis

Question 15

symptom of central retinal artery occlusion

Answer 15

sudden, painless, SEVERE loss of vision

Question 16

clinical sign of central retinal artery occlusion

Answer 16

RAPD

Question 17

what is RAPD

Answer 17

relative afferent pupil defect

Question 18

3 findings on fundoscopy of central retinal artery occlusion

Answer 18

arteries become thread like
retina is pale, opaque and oedematous
cherry-red spot seen at the fovea

Question 19

management of central retinal artery occlusion

Answer 19

immediate referral to stroke clinic

Question 20

3 factors that increase chance of retinal vein occlusion

Answer 20

VIRCHOW’S TRIAD
- endothelial damage
- abnormal blood flow
- hypercoagulable state

Question 21

central retinal vein occlusion

Answer 21

thrombus forms in the retinal veins and blocks the drainage of blood from the retina

Question 22

branch retinal vein occlusion

Answer 22

venous occlusion at any branch of the central retinal vein resulting in visual problems in the area drained by that branch

Question 23

what happens when a retinal vein is blocked

Answer 23

pooling of blood in the retina leading to macular oedema and retinal haemorrhages

Question 24

why can retinal vein occlusion lead to neovascularisation

Answer 24

release of VEGF

Question 25

symptom of retinal vein occlusion

Answer 25

sudden painless loss of vision

Question 26

4 findings on fundoscopy of retinal vein occlusion

Answer 26

• Flame and blot haemorrhages
• Optic disc oedema
• Macula oedema
• Dilated tortuous veins

Question 27

management of retinal vein occlusion

Answer 27

IMMEDIATE REFRRAL TO OPHTHALMOLOGY
laser photocoagulation, intravitreal steroids, anti-VEGF

Question 28

what is vitreous haemorrhage

Answer 28

bleeding in the vitreous cavity

Question 29

what are the 2 main mechanisms that cause vitreous haemorrhage

Answer 29

rupture of normal vessels from mechanical force
haemorrhage from pathological structures

Question 30

name 2 causes of retinal neovascularisation

Answer 30

diabetic retinopathy
retinal vein occlusion

Question 31

2 main symptoms of vitreous haemorrhage

Answer 31

sudden, painless visual loss or haze
new onset floaters

Question 32

clinical sign of vitreous haemorrhage

Answer 32

loss of fundal reflex