Visual loss

Question 1

what are causes of sudden visual loss

Answer 1

vascular, retinal detachment and age related macular degeneration

Question 2

what is the main artery of the eye

Answer 2

ophthalmic

Question 3

what are the 2 main branches that come off of the ophthalmic artery

Answer 3

central retinal artery, posterior ciliary artery

Question 4

what are vascular causes of sudden visual loss

Answer 4

occlusion of retinal artery and vein, optic nerve head circulation

haemorrhage from abnormal blood vessels and retinal tear

Question 5

what symptoms do you get with central retinal artery occlusion

Answer 5

sudden visual loss, counting fingers or less, painless

Question 6

what would the fundoscopy of th eye look like in a retinal artery occlusion

Answer 6

pale, oedematous retina with thread like retinal vessels

Question 7

is central retinal artery occlusion a type of a stroke?

Answer 7

yes it is!

Question 8

how would you manage a central retinal artery occlusion if it presents within 24 hours

Answer 8

ocular massage- push emboli down to a branch as opposed to a main artery

establish source of emboli- carotid doppler and assess ask factors

Question 9

what is amaurosis fugax

Answer 9

transient- blindness lasts 5 mins

Question 10

what should you do if a patient presents with transient painless visual loss- refer to TIA clinic

Answer 10

refer to TIA clinic and give them aspirin

Question 11

what is virchows triad

Answer 11

atherosclerosis, hypertension and hyperviscosity

Question 12

what are causes of CRVO

Answer 12

virchows triad and raised intra ocular pressure

Question 13

what are symptoms and signs of CRVO

Answer 13

sudden visual loss, retinal haemorrhages, dilated tortuous veins and disc swelling and macular swelling

Question 14

what new treatment has been used in CRVO

Answer 14

Anti vascular epithelial growth factor- prevent growth of new blood vessels

Question 15

what is ischaemic optic neuropathy

Answer 15

occlusion of the optic nerve head circulation

Question 16

what arteries get occluded in ischaemic optic neuropathy

Answer 16

posterior ciliary arteries

Question 17

what are the 2 types of ischaemic optic neuropathy

Answer 17

arteritic- inflammation and non-arteritic atherosclerosis

Question 18

what is the main cause of arteritic ION

Answer 18

giant cell arteritis

Question 19

what would the optic disk look like in ischaemic optic neuropathy

Answer 19

pale, swollen disc

Question 20

what are visual symptoms of Giant cell arteritis

Answer 20

sudden visual loss, profound (counting fingers ect) and IRREVERSIBLE BLINDNESS

Question 21

what are extra ocular symptoms of GCA

Answer 21

headache, jaw claudication, scalp tenderness, tender/ enlarged arteries

Question 22

why is it important to recognise temporal arteritis early

Answer 22

to prevent blindness in the other eye

Question 23

what drug may help prevent blindness in other eye of GCA

Answer 23

steroids

Question 24

where does a haemorrhage most commonly occur

Answer 24

vitreous cavity

Question 25

what is normally associated with bleeding from normal retinal vessels

Answer 25

retinal tear

Question 26

what is associated with bleeding from abnormal vessels

Answer 26

retinal ischaemia and new vessel formation

Question 27

what are sings and symptoms of a vitreous haemorrhage

Answer 27

loss of vision and floaters, loss of red reflex

Question 28

how do you treat a non resolving vitreous haemorrhage

Answer 28

vitrectomy

Question 29

what symptoms are associated with retinal detachment

Answer 29

painless loss of vision, sudden flashes, floaters

Question 30

how do you normally manage a retinal detachment

Answer 30

surgical excision?

Question 31

if there is a defect at bottom of retina, what will happen to the image we see?

Answer 31

it will be defective in TOP part

Question 32

what is the commonest cause of blindness in western world over 65

Answer 32

age related macular degeneration

Question 33

what is the difference between dry and wet AGMD

Answer 33

``` dry= gradual reduction wet= sudden reduction ```

Question 34

what happens in wet ARMD

Answer 34

new blood vessels grow under retina- leakage causes build up of fluid and blood causing scarring

Question 35

can you get distortion in wet ARMD

Answer 35

yes- metamorphoPSIA

Question 36

what is a sign of wet ARMD

Answer 36

haemorrhage or exudate

Question 37

how do you treat wet ARMD

Answer 37

Anti VEGF treatment

Question 38

what is associated with gradual visual loss

Answer 38

bilateral, asymmetrical, reduced visual acuity

Question 39

what does CARDIGAN stand for as the pneumonic for gradual visual loss

Answer 39

``` cataract ARMD refractive error diabetic retinopathy Inherited diseases glaucoma access to eye clinic= Non urgent ```

Question 40

what is the management of a cataract

Answer 40

surgical removal with intraocular lens implant

Question 41

what is a cataract

Answer 41

clouding of the lens due to congenital, age related, traumatic, diabetes, drug induced

Question 42

what is dry ARMD

Answer 42

gradual decline in vision

Question 43

what is a scotoma

Answer 43

blind spot

Question 44

what are signs of dry ARMD

Answer 44

drusen, atrophic patches of retina

Question 45

what is the treatment of dry aRMD

Answer 45

magnifying aods only- no cure

Question 46

what is refractive error

Answer 46

eye cannot focus on image clearly

Question 47

what is glaucoma

Answer 47

progressive degeneration of eye due to increased ocular pressure

Question 48

what is the angle glaucoma

Answer 48

angle between cornea and iris

Question 49

what does glaucoma result in

Answer 49

optic nerve damage

Question 50

how do you treat glaucoma

Answer 50

lower IOP with eye drops/ medication to preventblindness

Question 51

how does one preset with closed- angle glaucoma

Answer 51

painful, red eye, nausea, headache

Question 52

what are sings in open angled glaucoma

Answer 52

cupped disk, visual field defect, high IOP, usually no symptoms