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Ophthalmology > Visual Loss > Flashcards

Visual Loss Flashcards

(66 cards)

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1
Q

What are the main causes of sudden visual loss?

A

vascular; retinal detachment; ARMD- wet type

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2
Q

What is the ophthalmic artery a branch of ?

A

ICA

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3
Q

What artery supplies the inner 2/3rds of the retina?

A

central retinal artery

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4
Q

Which artery supplies the outer 1/3rd of the retina?

A

posterior ciliary artery

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5
Q

What are the 2 types of vascular problems?

A

occlusion and haemorrhage

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6
Q

Where can haemorrhage causing sudden visual loss come from?

A

abnormal blood vessels; retinal tear

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7
Q

What are the symptoms of central retinal artery occlusion?

A

sudden profound (counting fingers or less) visual loss; painless

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8
Q

What are the signs of central retinal artery occlusion?

A

RAPD; pale, oedematous retina, thread like retinal vessels

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9
Q

What is RAPD?

A

relative afferent pupil defect

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10
Q

How is RAPD tested?

A

swinging light test

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11
Q

What is the pupillary reflex pathway?

A

optic nerve–pretectal nucleus–edinger westphal nuclei–inferior division of CNIII–ciliary ganglion–short ciliary nerve

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12
Q

What are the causes of CRAO?

A

carotid artery disease; emboli from heart (unusual)

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13
Q

What is the management of CRAO if presents within 24 hours?

A

ocular massage to try and move embolus from CRA to a branch

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14
Q

What is the general mamagnemt of CRAO?

A

establish source of embolus- carotid doppler; assess and manage risk factors

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15
Q

What is amaurosis fugax?

A

traniset CRAO

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16
Q

What are the symptoms of transient CRAO?

A

transient painless visual loss for 5 mins “like a curtain coming down”;

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17
Q

What is the managemnt for amaurosis fugax?

A

immediate referral to TIA; aspirin

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18
Q

What else can cause transient visual loss?

A

migraine

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19
Q

How is migraine differentiated from amaurosis fugax?

A

migraine visual loss is usually followed by headache

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20
Q

How does a raised IOP affect Virchow’s triad?

A

causes venous stasis

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21
Q

What are the symptoms of CRVO?

A

sudden visual loss- mod to severe

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22
Q

What are the sings of CRVO?

A

retinal haemorrhages; dilated tortuous veins and disc and macular swelling; cotton wool spots- infarcts of nerve fibre layer

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23
Q

What are hte complications of CRVO?

A

new vessel formation which are ffragile and can haemorrhage into the vitreous layer

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24
Q

What is the treatment for CRVO?

A

tx of systemic or ocular causes- and prevent new vessels by laser treatment or anti-VEGFs

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25
What are the anti-VEGF?
drugs that are injected intra-vitreously-- anti- vascular endothelial growth factor
26
What is the gross difference in fundoscopy between artery and vein occlusions?
arterial is pale, vein occlusion is dark
27
What can be occluded in sudden visual loss?
retinal circulation or optic nerve head circulation
28
What is occlusion of optic nerve head circulation also known as?
ischaemic optic neuropathy
29
What arteries supply the optic nerve head?
psoterior ciliary arteries
30
What are the 2 types of ischaemic optic neuropathy?
arteritis-inflammation and non-arteritis- artherosclerosis
31
What are the signs of ischaemic optic neuropathy?
sudden, profound visual loss with swollen disc
32
What typically causes arteritic ischaemic optic neuropathy?
GCA
33
What is the inflammation in GCA?
infliltration of medium to large sized arteries by mulitnucleate giant cells
34
Why is immediate treatment of GCA importnat?
may prevent bilateral visual loss- irreversible
35
What are the symptoms of GCA?
headache; jaw claudication; scalp tenderness; tender/enlarged scalp arteries; amaurosis fugax; malaise; +++ESR, PV, CRP;
36
What can cause a vitreous haemorrhage?
from abnormal vessels- associated with retinal ischaemia and new vessel formation ; or normal retinal vessels- retinal tear
37
What are the signs of a vitreous haemorrhage?
loss of vision; floaters; loss of red reflex;
38
What are the symptoms of retinal detachment?
painless loss of vision; sudden onset of flashes/floaters
39
what causes the flashes of light in retinal detachment?
the mechanical separation of sensory retina stimulates the receptors which is seen as light
40
What is the treatment for a retinal tear?
drain fluid which has seeped into behind the retina and seal the tear- surgery
41
What type of visual loss would an inferior retinal detachment cause?
superior
42
What is the commonest cause of blindness in patients over 65 in the west?
ARMD
43
What are hte 2 types os ARMD?
dry and wet
44
What happnes in wet ARMD?
new blood vessels grow under retina- leakage causes build up of fluid/blood and eventual scarring
45
What is the function of the pigment cells in the retina?
help absorb light and cell turnover of photoreceptors- needs to be close to retina
46
What is contained within the choroid?
vascular arteries from PCA
47
What are the signs and symptoms of wet ARMD?
rapid central visual loss and distortion; haemorrhage or exudate on fundoscopy
48
What is the treatment for wet ARMD?
anti-VEGF
49
What are the causes of gradual visual loss?
``` CARDIGAN- Cataracts ARMD (dry) Refractive error Diabetic retinopathy Inherited disease Glaucoma Access (to eye clinic) Non-urgent ```
50
What is cataracts?
cloudiness of the lens
51
What are some of the causes of cataracts?
age related; congenital; traumatic; diabetes; steroid
52
What is the treatmnet for cataracts?
surgical removal with intra-ocular lens implant if patient is symptomatic
53
What are the signs of dry ARMD?
gradual decline in vision; central vision missing (scotoma); drusen- build up of waste products below RPE; atropjic patches of retina
54
What is the treatment for dry ARMD?
supportive with vision aids
55
What is a refractive error?
eye cannot clearly focus image
56
What is myopia?
short sighted
57
What is hypermetropia?
long sighted
58
What is astigmatism?
irregular corneal curvature
59
What is presbyopia?
loss of accomodation with aging
60
What is glaucoma?
progressive optic neuropathy
61
What does glaucoma ultimately result in?
optic nerve damage and therefore visual loss
62
What is closed angle glaucoma?
fluid builds up and iris is pushed forward, shutting off angle
63
What is the presentation of closed angle glaucoma
painful, red eye/visual loss/ headache/ nausea/vomiting
64
What is the only modifiable risk factor in glaucoma?
IOP
65
What are the symptoms for closed-type glaucoma?
often none, optician may discover
66
What are the signs of open angle glaucoma?
cupped disc; visual field defect

Ophthalmology (10 decks)

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