Vision Loss.

Question 1

Features of central retinal artery occlusion

Answer 1

Sudden painless profound loss of vision.

RAPD
Pale, oedematous retina.
Cherry red spot on macula.

Question 2

Management of CRAO?

<24 hours and > 24 hours.

Answer 2

> 24 hours - nothing

12-24hours:

• Try Convery central to branch with ocular massage
• IV acetazolmide.

Question 3

Prognosis of CRAO?

Answer 3

Prognosis is poor and vision loss is permanent.t

Further management is aimed at preventing it from happening in the other eye.

Question 4

What is amaurosis fugax?

Answer 4

Essentially a TIA of the central retinal artery.

Sudden painless loss of vision “curtain coming down”

Rx secondary prevention,

Question 5

Retinal appearance of central retinal vein occculsion?

Answer 5

Stormy sunset.

Retinal flame haemorrhages.

Dilated tortuous veins.

Swollen optic disc.

Question 6

Management of central retinal vein occlusion?

Answer 6

Observe and allow time to heal.
If ischaemia you can give anti-VEGF

Outcomes are variable with different degrees of vision return.

Question 7

Giant cell arteritis is the cause os ischaemic optic neuropathy

Answer 7

Present with sudden vision loss with headache, jaw claudication and scalp tenderness.

Vision loss in affected eye is permanent, the steroids that you give aims to prevent vision loss in the other eye.

Question 8

Sudden painless vision loss with flashes and floaters.

Loss of red reflex and no RAPD.

Answer 8

Vitreous haemorrhage.

Question 9

If neovasuclatisation is present, what can you do?

Answer 9

Give Antione-veg f

Question 10

Sudden painless visual loss with flashes, floaters and loss of visual field that lasts longer than.5 minutes?

Answer 10

Retinal detachment

Question 11

Prognosis of retinal detachment?

Answer 11

Prognosis is usually good and vision will return especially if macula hasn’t detached.

Question 12

What is optic neuritis?

Answer 12

Inflammation of the optic nerve.

Question 13

Causes of optic neuritis?

Answer 13

MS, ethambutol.

Question 14

Presentation of optic neuritis?

Answer 14

Painful eye movements
Dull ache behind eye
Central scotoma
Reduced colour vision

Question 15

You get a cereal scotoma in optic neuritis, what is this?

Answer 15

Loss of central field of vision.

Question 16

You get loss of colour vision in optic neuritis, what colour?

Answer 16

Especially red desaturation.

Question 17

Management of optic neuritis?

Answer 17

INvestigate for MS.

Most resolve spontaneously.

IV steroids may help, oral steroids can worsen it.

Question 18

How is Best’s disease inherited?

Answer 18

Autosomal dominant disease of the macula

Question 19

When does Best’s disease present?

Answer 19

Childhood or early adulthood.

Question 20

Macula appearance of bests disease?q

Answer 20

Scrambled/ egg yolk appearance on macula.

Question 21

How do you investigate ARMD?

Answer 21

Ocular coherence tomography.

Question 22

Metamorphopsia occurs in what disease?

Answer 22

WET ARMD.

Question 23

Management of Wet ARMD?

Answer 23

Anti-VEGF

Question 24

Retinal appearance of dry ARMD?

Answer 24

Atrophic macula - hypopigmentation.

Drusen around the macula.

Question 25

Wet ARMD presentation?

Answer 25

Sudden, painless loss of vision with metamorphopsia and surrounding haemorrhages.

Question 26

Dry ARMD presentation?

Answer 26

Bilateral loss of central vision with maintenance of peripheral vision

Main cause of blindness in western populations.

Question 27

What is used to identify distortion of vision in Wet ARMD?

Answer 27

Amsler grid.

Question 28

What is a cataract?

Answer 28

Lens opacity.

Note: steroids can cause cataracts.

Question 29

Presentation of cataracts?

Answer 29

Gradual vision loss with blurring of vision., dazzling by bright light and difficult reading.

Reduced red reflex.

Question 30

How are cataracts managed?

Answer 30

Phacemulsifaction.