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Pathologies of eye > Vision loss > Flashcards

Vision loss Flashcards

1
Q

What tests to do to examine vision loss?

A
  • Fondoscopy: direct opthalmoscope, slit lamp and Volk lens
  • Snellen chart

Ancillary tests:

  • Amsler chart
  • Colour vision
  • Visual field
  • Fundus Flurescin angiography
  • Optical coherence tomography (OCT) : allows you to see a clear image of the retina
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2
Q

Sudden complete loss of vision

A
  • Central retinal artery occlusion

- Anterior ischaemic optic neuroapthy

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3
Q

Central retinal artery occlusion treatment

A

Intra-vitreal anti-vegF

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4
Q

What does anterior ischaemic optic neuropathy involve?

A

Short posterior ciliary arteries

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5
Q

Which are the two types of anterior ischeamic optic neuropathy?

A

Arteritic

Non-arteritic

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6
Q

Symptoms of anterior ischeamic optic neuropathy

A
  • Loss of vision
  • Headaches
  • Loss of appetite
  • Scalp tenderness
  • Pain when chewing : due to ischaemic masseter (innervated by same blood vessels)
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7
Q

Signs of anterior ischaemic optic neuropathy

A

-Tenderness on superficial temporal arteries
-Raised inflammatory markers
(High CRP/ ESR)

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8
Q

Treatment of anterior ischeamic optic neuropathy

A

High dose steroids

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9
Q

Gradual vision loss diseases

A
  • Catarracts
  • Glaucoma
  • Age-related macular degeneration
  • Diabetic retinopathy
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10
Q

Catarracts

  • what is it
  • symptoms
  • management
A

Commenest cause of blindness in the UK

Opacification of the lens : when light comes into the lens it is broken down

Symptoms:

  • Loss of vision
  • Glare

Management
Surgery :
-commonest surgery in the UK as an age related issue and as we all know there is an ageing population

  • Local anaestetic
  • Incision into lens
  • Phacoemulsification: breaks down the lens
  • Lens resected and clear capsular bag is inserted instead
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11
Q

Glaucoma

  • What is it
  • Two different types
A

Optic neuropathy associated with optic nerve damage. Due to an increase in intraocular pressure which leads to visual field changes.

Can be :
-Open/Chronic : the trabecular meshwork which drains the eye is not anatomically blocked. Acqueos humour keeps on being produced in the ciliary body which leads to an increase in intraocular pressure.

-Closed/acute: When the eye cannot be drained properly. Canal can suddenly close
Investigation

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12
Q

Glaucoma

  • symptoms
  • signs
  • treatment
A

Symptoms:

  • Loss of vision
  • Nausea
  • Pain
  • Poor vision

Signs:

  • Increased intraocular pressure
  • Visual field defect (peripheral)
  • optic disc damage

Treatment

  • Topical treatment
  • Surgery: trabeculectomy
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13
Q

Age related macular disease

  • What is it
  • Two types
A

Damage to the macula- responsible for seeing fine details clearly
Can be:
-Dry (90%)/Atrophic

-Wet/ neovascular

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14
Q

Dry ARMD

A
  • Atrophy: loss of central vision
  • Macula become stained with these druse
  • Treat with vision aids
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15
Q

Wet ARMD

A
  • Formation of new blood vessels which grow towards the macula
  • They are weak and therefore they burst easily leading to the macula being impaired
  • Investigate with OCT and fluorescing angiography
  • Manegement: intravitreal antivegf , Low vision aid, registration
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16
Q

What is intravitreal antivegf

A

hey stop the neovasculature from bleeding- it promotes growth of vessels

17
Q

Diabetic retinopathy

  • cause
  • signs
  • investigation
  • management
A

Signs:

  • Microaneurysms (swelling on capillaries)
  • Retinal hemorrages and exudates
  • Neovascularisation on the disc or the retina

Investigations:

  • OCT
  • Flurescin angiography

Management:

  • Intravitreal antivegf
  • laser
  • low vision aids
  • registration
18
Q

What is OCT?

A

A cross sectional scan of the macula

19
Q

How does fundus flurescin angiography work

A

Fluorescein dye injected

  • > Binds to blood proteins
  • > Blue light shone in and excites the fluorescein
  • > Light returns and the yellow-green light is isolated with a filter
  • > Yellow-green light shows shines on a film
  • > Fluorescein filled vessels appear white

This will help you spot any blockages or bleeds from an optical artery

20
Q

What causes central retinal artery occlusion

A
  • Emboli

- Inflammation

21
Q

What causes central retinal vein occlusion

A
  • Hypertension
  • Glaucoma
  • Hyperviscosity
  • Inflammation
22
Q

Appearance of CRAO and CRVO

A 
CRVO:
- The retina is darker
- Tortuous dilated veins
- Macular & Optic Disc Oedema
All because of the back up of blood

CRAO:

  • Pale
  • Conspicuously lacking blood

Pathologies of eye (2 decks)

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