Vision Loss And Blindness Flashcards
What is the major blood supply to the eye
Ophthalmic artery branches
What are the signs/symptoms of a CRAO
Sudden profound vision loss
Painless
RAPD
pale oedematous retina with thread like retinal vessels
What is a key feature of a CRAO
Cherry red spot- normal fovea easily seen against pale background
What are the causes of CRAO
Carotid artery disease
Emboli from the heart (unusual)
Giant cell arteritis
CRAO is a form of stroke
What are the symptoms of amaurosis fugax (transient CRAO)
Transient painless Vision loss (like a curtain coming down)
Lasts 5 mins with full recovery
Usually nothing abnormal on examination
Refer to stroke unit
What are the symptoms/signs of CRVO?
Sudden vision loss
Retinal haemorrhages
Dilated tortuous veins
Disc and macular swellings
What is ischaemic optic neuropathy
Occlusion of the optic nerve head
Posterior ciliary arteries become occluded
What are the symptoms of GCA
Headache/scalp tenderness
Enlarged temporal arteries
How is GCA treated
Steroids
What is vitreous haemorrhage?
Bleeding from abnormal new blood vessels which have grown due to ischaemia eg in diabetes
OR
bleeding from normal retinal vessels eg bridging a retinal tear
What kind of vision loss does a vitreous haemorrhage cause?
Sudden Vision loss
What are the symptoms of a retinal detachment?
Painless loss of vision/visual field defect
Sudden onset of flashes/floaters
What are the signs of retinal detachment
RAPD
May see tear on ophthalmoscopy
What does a detachment at the bottom of the eye mean?
Loss of vision at the top
What is ARMD?
Commonest cause of blindness in the UK
unknown cause
What are the types of ARMD?
Wet- sudden vision loss
Dry- gradual vision loss
What is wet ARMD
New blood vessels grow under retina, leakage causes a build up of fluid/blood and eventually scarring
What are some signs/symptoms of wet ARMD
Rapid central vision loss
Distortion
Haemorrhage/exudate
What are the features of glaucoma
Results in optic nerve damage
Pathogenesis is not well understood
Lots of different types of glaucoma
What causes a closed angle glaucoma?
Aqueous humour has increased resistance through iris/lens channel
This causes peripheral angle to bow forwards obstructing trabecular meshwork
What are the signs/symptoms of a closed angle glaucoma?
Painful eye
Sudden visual loss
Headache
Nausea
Red eye
Cloudy cornea
Hard eye
Mid dilated pupil
Must lower IOP
What is cataracts?
Cloudiness of the lens
What are some causes of cataracts?
Age related
Congenital
Metabolic
Drug induced
Intra uterine infection
What are some cataract symptoms?
Gradual vision loss (hazy/blurred)
Loss of red reflex
What is the management of cataracts?
Management is surgical removal (phacoemulsification) with an intra ocular lens implant if patient is symptomatic
What are the symptoms/signs of dry ARMD
Gradual decline in vision
Central vision missing (scotoma)
Drusens sign- build up of waste products below RPE
Atrophic patch of retina
What is the treatment for dry ARMD
No cure
Supportive treatment only
Low vision aids
Visual impairment registration
Social support
What causes open angle glaucoma?
Connective tissue beams forming trabecular meshwork- reduced aqueous outflow here causes increased IOP
What are the signs/symptoms of open angle glaucoma?
Often no symptoms
May/may not have high IOP
Cupped disc= loss of retinal ganglion cells
Visual field defects
What does a larger optic cup mean?
More damage caused by glaucoma
