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Opthalmology > Visual loss > Flashcards

Visual loss Flashcards

1
Q

How would central retinal artery occlusion present?

A

Sudden, painless visual loss in one eye

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2
Q

What signs on examination would indicate a central retinal artery occlusion?

A

Cherry red spot at the macula

RAPD

Pale, oedematous retina

Thread-like retinal vessels

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3
Q

How is central retinal artery occlusion managed?

A

Ocular massage to change to branch retinal artery occlusion

Carotid Doppler to find source of clot

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4
Q

What is the diagnosis here?

A

Central retinal artery occlusion

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5
Q

What is the name given to transient central retinal artery occlusion?

A

Amaurosis fugax

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6
Q

How does amaurosis fugax present?

A

Transient painless visual loss lasting ~5 minutes

‘Like a curtain coming down’

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7
Q

What signs on fundoscopy would indicate central retinal vein occlusion?

A

Retinal haemorrhages

Dilated tortuous veins

Disc swelling and macular swelling

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8
Q

What is the diagnosis here?

A

Central retinal vein occlusion

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9
Q

How is central retinal vein occlusion managed?

A

Treat systemic cause e.g. hypertension, glaucoma

Monitor: complications may arise if new vessels develop

Anti-VEGf

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10
Q

What is ischaemic optic neuropathy?

A

Posterior ciliary arteries become occluded, resulting in infarction of the optic nerve head

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11
Q

What are the two kinds of ischaemic optic neuropathy?

A

Ateritic - inflammation

Non-arteritic - atherosclerosis

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12
Q

What signs on fundoscopy would indicate amaurosis fugax?

A

Normally no signs on fundoscopy

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13
Q

What is the management for amaurosis fugax?

A

Urgent referral to TIA clinic

Aspirin

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14
Q

What signs would indicate optic neuritis?

A

Sudden, profound visual loss

Swollen disc

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15
Q

What is the pathogenesis of arteritic ischaemic optic neuropathy?

A

Giant cell arteritis (GCA)

Medium to large sized arteries inflamed (multinucleate giant cells)

Lumen of artery becomes occluded (posterior ciliary arteries)

Visual loss from ischaemia of optic nerve head

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16
Q

What are the signs and symptoms of giant cell arteritis?

A

Headache (usually temporal)

Jaw claudication

Scalp tenderness (painful to comb hair)

Tender/enlarged

Scalp arteries

Amaurosis fugax

Malaise

17
Q

What investigations should be done for giant cell arteritis?

A

ESR, PV and CRP (all raised in GCA)

Temporal artery biopsy

18
Q

What is the treatment for visual loss due to giant cell arteritis?

A

Immediate high dose systemic steroid to prevent visual loss in the other eye

19
Q

What is a vitreous haemorrhage?

A

Haemorrhage into the vitreous cavity

20
Q

Where does haemorrhage occur from in the eye?

A

Abnomal vessels (i.e. neovascularisation or retinal ischaemia)

Retinal vessels

21
Q

What are the symptom of vitreous haemorrhage?

A

Loss of vision

Floaters

22
Q

What are the signs of vitreous haemorrhage?

A

Red eye

Loss of red reflex

23
Q

How does retinal detachment present?

A

Painless loss of vision

Sudden onset flashes and floaters

24
Q

What signs on examination would indicate retinal haemorrhage?

A

May have RAPD

May see tear on opthalmoscopy

25
Q

What is the most common cause of blindness in the Western world in patients over 65?

A

Age-related macular degeneration

26
Q

Which type of macular degeneration presents with sudden reduction in vision?

A

Wet

27
Q

Which type of macular degeneration presents with a gradual reduction in vision?

A

Dry

28
Q

What is the pathogenesis of wet age-related macular degeneration?

A

New blood vessels grow under retina

Leakage from these vessels causes build up of fluid/blood and eventually scarring

29
Q

What are the symptoms of wet ARMD?

A

Rapid central visual loss

Metamorphosia/distortion

30
Q

What signs on fundoscopy would indicate wet ARMD?

A

Haemorrage/exudate

New vessels

31
Q

What is the treatment for wet ARMD?

A

VEGF injections into vitreous cavity

32
Q

What is the treatment for symptomatic cataracts?

A

Surgical removal with intra-ocular lens implant

33
Q

What are the symptoms of dry ARMD?

A

Central vision ‘missing’

Gradual visual loss

34
Q

What is myopia?

A

Short-sighted refractive error

35
Q

What is hypermetropia?

A

Long-sighted refractive error

36
Q

What is astigmatism?

A

Usually irregular corneal curvature

37
Q

What is presbyopia?

A

Loss of accomodation with ageing

38
Q

What is the treatment for open-angle glaucoma?

A

Pressure-lowering eye drops

Occasionally surgery

Need monitoring in clinic

Opthalmology (10 decks)

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