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4th Year Ophthamology > Vision Loss > Flashcards

Vision Loss Flashcards

1
Q

Name 6 important parts of a patients history regarding vision loss?

A 
Speed of onset
Painfulness
Extent of loss
Associated symptoms
Padt ocular history
Past medical history
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2
Q

Name 4 causes of gradual vision loss

A

Cataract
Age related macular degeneration
Chronic open angle glaucoma
Diabtetic retinopathy

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3
Q

What are common causes of cataracts?

A 
Age
Congenital
Trauma
Metablolic
Drugs
Intra-uterine infections
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4
Q

Name 4 subtypes of cataract?

A

Nuclear sclerotic
Cortical (snowflake)
Posterior Subcapsular
Mature (white)

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5
Q

What were previous treatments for cataracts?

A

Intra-capsular cataract extraction (ICCE)

Extra-capsular cataract extraction (ECCE)

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6
Q

What is the routine treatment for cataracts nowadays?

A

Phaco-emulsification with intra-ocular lens implantation

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7
Q

What type of vision loss occurs with macular degeneration?

A

Central vision

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8
Q

Describe dry age related macular degeneration?

A

Wear and tear of retinal pigment epithelium (RPE)
Deposition of druse and RPE hypo/hyperpigmentation
Slow, progressive drop in central VA

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9
Q

What can help with dry age related macular degeneration?

A

Low visual aids
Dietary/smoking advice
Amsler grid
Blind registration

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10
Q

Describe wet age related macular degeneration?

A

Eye grows new blood vessels within macula to try and repair dry macular degeneration.
Vessels leak fluid into retinal tissue
Sudden drop in central VA
Assoc. metamorphopsia

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11
Q

What investigations can be done for wet age related macular degeneration?

A

Ocular Coherance Tomography (OCT)

Fundus Flourescene Angiography (FFA)

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12
Q

How do you treat wet age related macular degeneration?

A

Anti-VEGf e.g. Ranibizumb (lucentis)
Monoclonal antibodies
Inhibiting the growth of new vessels
Argon lasers and photo-dynamic therapy

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13
Q

What are painless causes of sudden visual loss?

A 
Central retinal artery occlusion
Central retinal vein occlusion
Ischaemic optic neuropathy 
Amaurosis fugax
Retinal detachment
Vitreous haemorrhage
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14
Q

What are painful causes of sudden visual loss?

A

Acute angle closure glaucoma
Optic neuritis
Giant cell arthritis

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15
Q

Describe central retinal artery occlusion

A

Sudden, profound loss <6/60
RAPD
Pale, swollen retina with cherry red spot at macula

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16
Q

What are causes of central retinal artery occlusion?

A

GCA
Embolic - calcific heart valves, vegetations
thrombus

17
Q

What is the treatment for CRAO?

A 
Only effective within 12-24hrs
Occular massage
Paper bag breathing
IV Diamox
Anterior chamber paracentesis
18
Q

What are the features of central retinal vein occlusion?

A 
Moderate to severe visual loss
RAPD
Retinal flame haemorrhages (stormy sunset)
Tortuous vessels
Swollen disc
Cotton wool spots
Neovascularisation (if longstanding)
19
Q

How do you treat CRVO?

A

no ischaemia - observe every 3 months
Ischaemia but no neovascularisation - observe every 4-6 weeks
Neovascularisation and ischeamia - Urgent argon laser pan-retinal photocoagulation

20
Q

What should be ruled out with Anterior Ischaemic Optic Neuropathy (AION)?

A

GCA

21
Q

How does no artertic AION present?

A

45-65 years
Hypermetropes with small crowded optic discs
smokers

22
Q

What symptoms occur with a retinal detachment?

A

Persisting flashing lights
Burst of new floaters
Dark shadow in peripheral vision, increasing in size

23
Q

In who is a retinal detachment more common in?

A

Myopes

24
Q

What surgical procedures can help a detached retina?

A

Scleral buckle
Internal approach with vitrectomy/laser or cryotherapy/ bubble of gas to act as internal tamponade - posture needs to be correct for 10 days to position bubble correctly.

25
Q

Symptoms of optic / retrobulbar neuritis?

A

Loss of vision over few days
Washed out colours
Dull ache on eye movements

26
Q

Signs optic / retrobulbar neuritis?

A 
Decreased VA
RAPD
Decreased colour vision
Enlarged blind spot
Optic disc swelling (not in retrobulbar)
27
Q

How do you treat optic / retrobulbar neuritis?

A 
Interferon B
Not steroids (may worsen)
28
Q

Describe Horner’s syndrome?

A

Paralysis of sympathetic supply to eye
Mild ptosis
Constricted pupil which does not dilate
Reduced ipsilateral sweating

29
Q

What are causes of Horner’s syndrome?

A 
Pancoast tumours
Carotid /Aortic aneurysms
Lesions of neck
Congenital 
Idiopathic

4th Year Ophthamology (6 decks)

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