Vision Loss Flashcards
Give causes of sudden visual loss
vascualr retinal detachment ARMD- wet type closed angle glaucoma optic neuritis stroke
What are the symptoms of centrlal retinal artery occlusion
sudden visual loss
profound
painless
What are the signs of CRAO
RAPD
pale oedematous retina, thread like retinal vessels
What are the causes of CRAO and which is most common
carotid artery disease - most common
emboli from heart
How are CRAO patients managed
if presents within 24 hrs- ocular massage
carotid dopples
assess and manage risk factors
What is amaurosis fugax
a transient CRAO
What are the symptoms of a tranient CRAO
painless visual loss like a curtain coming down
lasts less than five minutes with a full recovery
usually no abnormal examination findings
How should transient CRAO patients be managed
refer to TIA clinic
aspirin
What are the systemic and ocular causes of central retinal vein occlusion
Systemic= virchow’s traid - atherosclerosis, hypertension and hyperviscosity
Ocular causes= reaised intra occular pressure (venous stasis)
What are the symptoms of central retinal vein occlusion
sudden vision loss
moderate to sever visual loss
What are the sings of crvo
retinal haemorrhages
dilated tortuous veins
disc swelling and macular swelling
What is ischaemic optic neuropathy
pcclusion of the optic nerve hear circulation ie occlusion of the posterior ciliary arteries resulting in infarction of the optic nerve head
What are the two types of ischaemic optic neuropathy
arteriritc - inflammation
non arteritic- atherosclerosis
Both cause sudden profound vision loss with a swollen disc
Describe the pathogenesis of arteritic ischaemic optic neuropathy
Giant cell arteritis- medium to large sized arteries become inflammed and lumen of arteries becomes occlued (PCA) resulting in vision loss due to ischaemia of the optic nerve head
What are the visual symptoms of arteritic ischaemic neuropathy
sudden vision loss
profound blindness
irreversible blindness
What are the sympotms of giant cell temporal arteritis
headache jaw claudication scalp tenderness tender enlarged scalp arteries amayrosis fugax malaise high ESR, PV and CRP biopsy for diagnosis
How can you prevent bilateral blindness in a patient with arteritic ischaemic neuropathy due to giant cell arthertisi
immediate steroids
What can give you a vitreous haemorrhage
bleeding from abnormal vessels eg retinal vein occlusion or diabetic retinopathy
Bleeding occurs from retinal vessels eg with a retinal tear
What are the symptoms of a vitrous haemorrhage
loss of vision
floaters
What are the signs of vitreous haemorrhage
loss of red reflex
No RAPD
What are symptoms of retinal detachment
painless loss of vision
sudden onset of flashes/floaters
What signs may be present in retinal detachment
RAPD
tear on opthalmoscopy
What are the two types of ARMD
dry (gradual vision loss)
wet (sudden)
What is wet ARMD
new blood vessels grow under retina - leakage causes build up of fluid/blood and eventually scarring
What are the symptoms and signs of wet ARMD
rapid central visual loss
distortion (metmorphosia)
sign- haemorrhage/exudate
How is wet ARMD treated
anti VEGF treatment - prevent new blood vessels growing
Give the causes of gradual vision loss
Cataract ARMD (dry) Refreactive error Diabetic retinopathy Inherited disease eg retinitis pigmentos Glaucoma Acces to eye clinic Non urgert 'CARDIGAN'
Name some causes of cataractd
age congenital traumatic diabetes drug induced (steroids)
What is the treatment of cataracts
management is surgical removal with intra ocular lens implat if patient is symptomatic
What are the symptoms of dry ARMD
gradual decline in vision
central vision missing
What are the signs of Dry ARMD
drusen- build up of waste products below retinal pigment epithelium
RPE changes- atrophy/hyperplasia
What is short sighted
myopia
What is long sighted
hypermetropia
What is an astigmatism
irregular corneal curvature
What is presbyopia
loss of accommodation with aging
