Vision los Flashcards
Causes of sudden vision loss
Painful: Acute glaucoma Optic neuritis GCA Anterior uveitis
painless and come and go:
Amaurosis fugax (lack of blood supply to eye)
Migraine
Raised ICP
Painless and constant:
Retinal detachment
Vitreous haemorrhage
Retinal vessel occlusion
Gradual
Cataracts
Refractive errors
Veil over eyes
Amaurosis fugax
red painful eye with hazy sudden loss of vision with mild dilation
Acute glaucoma
Other symptoms/signs in acute glaucoma
Cupped optic disc
Halo seen around lights
Criteria for MS
Two or more CNS lesions with corresponding symptoms separated in time and space (lasts for longer than 24h and at least one month apart)
e.g. tingling and optic neuritis
Symptoms of MS
Reduced visual acuity Double vision Nystagmus Burning sensation in eye Tremors Weakness Autonomic dysfunction (e.g. bladder or bowel problems)
What is Temporal arteritis?
Inflammation of temporal arteries, formation of granulomas causing ischemia
Symptoms + associated symptoms/distribution of pain in GCA
Unilateral headache in the distribution of the temporal artery
Pain upon eating (jaw claudication)
Pain when brushing hair
Double vision
Blurred vision
Vision Loss
Which condition is GCA associated with?
Associated with polymyagia rheumatica
Main cause of anterior uveitits
Autoimmune conditions
Symptoms and signs of anterior uveitis
Painful and increased lacrimation and photophobia
Blurring
Red watery eyes
Main cause of posterior uveitits
Infective
Symptoms of posterior uveitis
Painless
Floaters
Scotomata (vision changes e.g. in auras)
What is a migraine aura?
Speech disturbances, blurry vision
Who does migraine affect more?
Women
What is cataract + causes of cataracts
Opacification of the lens
Age related
DM retinopathy
Chronic glaucoma
Also steroids
What would someone with cataract see?
Glare from bright light
Halo around light
Washed out colour vision (e.g. less richness in the colours, esp blues)
Features of cataracts in someone with chronic glaucoma
Bilateral vision loss from periphery to inner side
Is it painful in cataracts?
No, gradual-onset painless loss of vision
What questions would you ask about the vision loss?
Unilateral or bilateral? Sudden or gradual onset? Clarify the vision loss (diplopia etc) Worse when coughing? (Raised ICP) How long does it last? When does it come on? Does anything make it better or worse?
What PMH might you ask about?
Previous Hx of eye problems Glaucoma MS Trauma to head/ face (retinal detachment) Previous Hx of migraines Atherosclerotic risk factors: hypertension, diabetes, dyslipidemia Autoimmune conditions Infections: varicella zoster virus
What might you ask about in FH?
Glaucoma/ Eye problems
CVS risk factors
Stroke/ TIAs
MS
