vision loss (sudden)

Question 1

causes of sudden, painless vision loss

Answer 1

ischaemic or vascular (thrombis, occlusion, temporal arteritis) // vitreous haemorrhage // retinal detachment // retinal migraine

Question 2

symptoms of amaurosis fugax

Answer 2

sudden curtain coming down

Question 3

what causes amaurosis fugax

Answer 3

vascular occlusion of ICA, opthalamic, or retinal artery // TIA, stroke

Question 4

what causes central retinal artery occlusion

Answer 4

thromboembolism (from athrosclerosis) or temporal arteritis

Question 5

symptoms + fundoscope central retinal artery occlusion

Answer 5

sudden painless, unilateral vision loss // RAPD (swinging light) // cherry red spot on pale retina // thin vessels

Question 6

RF Central retinal vein occlusion

Answer 6

age // HTN // cardiovascular disease // glaucoma // polycthaemia

Question 7

symptoms + fundoscope Central retinal vein occlusion

Answer 7

sudden, painless loss of vision or acuity // widespread red fundus // disc swelling // torturous and bulging vessels // macular oedema

Question 8

fundoscope branch retinal vein occlusion

Answer 8

limited area of fundus affected (occurs at atriovenous crossings)

Question 9

mx Central retinal vein occlusion

Answer 9

oedema = intravitreal anti VEGF // retinal neovascularisation = laser

Question 10

what causes ischaemic optic neuropathy

Answer 10

occlusion of posterior cilliary arteries (temporal arteritis)

Question 11

fundoscopy ischaemic optic neuropathy

Answer 11

pale and swollen disc

Question 12

what is vitreous haemorrhage

Answer 12

bleeding into vitreous humour from retinal vessel

Question 13

causes vitreous haemorrhage

Answer 13

diabetes!!! // posterior vitreous detatchment // trauma

Question 14

symptoms vitreous haemorrhage

Answer 14

painless vision loss or haze // red hue in vision // floaters or shadows // decreased visual acuity

Question 15

invx vitreous haemorrhage

Answer 15

slit lamp + fundoscope = blood in vitreous // USS for retinal tear // flurescein angio = neovascularisation // orbit CT = globe injury

Question 16

RF retinal detachment

Answer 16

diabetes // myopia (near sighted) // age // surgery // trauma

Question 17

symptoms retinal detachment

Answer 17

starts peripherally (dark curtain)!!! // sudden, painless, progressive // new floaters or flashers // if macula affected reduced acuity

Question 18

invx + fundoscopy retinal detachment

Answer 18

RAPD and loss of red reflex

Question 19

when is retinal detachment reversible/ irreversible

Answer 19

irreversible when macula affected

Question 20

mx retinal detachment

Answer 20

all new onset flashes/ floaters –> urgent ophthalmologist referral

Question 21

post is posterior vitreous detachment

Answer 21

separation from vitreous membrane from retina

Question 22

RF posterior vitreous detachment

Answer 22

age // myopic (near sighted)

Question 23

symptoms posterior vitreous detachment

Answer 23

sudden floaters // flashes of vision // blurred vision // dark curtain descending down

Question 24

invx posterior vitreous detachment

Answer 24

weiss ring // refer to ophthalmology

Question 25

complication posterior vitreous detachment

Answer 25

progression to retinal detachment

Question 26

mx posterior vitreous detachment

Answer 26

self limiting 6 months // if retinal tear –> surgery

Question 27

RF closed angle glaucoma

Answer 27

hypermetropia (long sighted) // pupil dilated // aging

Question 28

what is closed angle glaucoma

Answer 28

raised intraocular pressure with iris occluding trabecular meshwork so no outlet of aqueous humor

Question 29

symptoms closed angle glaucoma

Answer 29

severe pain // decreased acuity // worse when mydriasis (dilated pupil) // red eye // halo around light // semi-dilated, non reactive pupil!!! // N+V

Question 30

invx closed angle glaucoma

Answer 30

tonometry for IOP // slit lamp + gonioscopy

Question 31

referral closed angle glaucoma

Answer 31

urgent

Question 32

which eye drops can be used for closed angle glaucoma

Answer 32

combination of pilocarpine + timolol + apraclonidine

Question 33

IV mx for closed angle glaucoma

Answer 33

acetazolamide (reduces aqueous secretions)

Question 34

definite mx closed angle glaucoma

Answer 34

laser peripheral iridotomy

Question 35

action pilocarpine

Answer 35

parasympathomimetic –> contriction of ciliary muscle –> constrict pulil –> open trabecular network

Question 36

action timolol

Answer 36

decreased aqueous humour production

Question 37

action apraclonidine

Answer 37

alpha2 agonist –> decrease aqueous humour production + increase uveoscleral outflow

Question 38

action