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Ophthalmology > Visual Loss > Flashcards

Visual Loss Flashcards

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
Q

What are the anti-VEGF?

A

drugs that are injected intra-vitreously– anti- vascular endothelial growth factor

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26
Q

What is the gross difference in fundoscopy between artery and vein occlusions?

A

arterial is pale, vein occlusion is dark

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27
Q

What can be occluded in sudden visual loss?

A

retinal circulation or optic nerve head circulation

28
Q

What is occlusion of optic nerve head circulation also known as?

A

ischaemic optic neuropathy

29
Q

What arteries supply the optic nerve head?

A

psoterior ciliary arteries

30
Q

What are the 2 types of ischaemic optic neuropathy?

A

arteritis-inflammation and non-arteritis- artherosclerosis

31
Q

What are the signs of ischaemic optic neuropathy?

A

sudden, profound visual loss with swollen disc

32
Q

What typically causes arteritic ischaemic optic neuropathy?

A

GCA

33
Q

What is the inflammation in GCA?

A

infliltration of medium to large sized arteries by mulitnucleate giant cells

34
Q

Why is immediate treatment of GCA importnat?

A

may prevent bilateral visual loss- irreversible

35
Q

What are the symptoms of GCA?

A

headache; jaw claudication; scalp tenderness; tender/enlarged scalp arteries; amaurosis fugax; malaise; +++ESR, PV, CRP;

36
Q

What can cause a vitreous haemorrhage?

A

from abnormal vessels- associated with retinal ischaemia and new vessel formation ; or normal retinal vessels- retinal tear

37
Q

What are the signs of a vitreous haemorrhage?

A

loss of vision; floaters; loss of red reflex;

38
Q

What are the symptoms of retinal detachment?

A

painless loss of vision; sudden onset of flashes/floaters

39
Q

what causes the flashes of light in retinal detachment?

A

the mechanical separation of sensory retina stimulates the receptors which is seen as light

40
Q

What is the treatment for a retinal tear?

A

drain fluid which has seeped into behind the retina and seal the tear- surgery

41
Q

What type of visual loss would an inferior retinal detachment cause?

A

superior

42
Q

What is the commonest cause of blindness in patients over 65 in the west?

A

ARMD

43
Q

What are hte 2 types os ARMD?

A

dry and wet

44
Q

What happnes in wet ARMD?

A

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

45
Q

What is the function of the pigment cells in the retina?

A

help absorb light and cell turnover of photoreceptors- needs to be close to retina

46
Q

What is contained within the choroid?

A

vascular arteries from PCA

47
Q

What are the signs and symptoms of wet ARMD?

A

rapid central visual loss and distortion; haemorrhage or exudate on fundoscopy

48
Q

What is the treatment for wet ARMD?

A

anti-VEGF

49
Q

What are the causes of gradual visual loss?

A 
CARDIGAN-
Cataracts
ARMD (dry)
Refractive error
Diabetic retinopathy
Inherited disease
Glaucoma
Access (to eye clinic)
Non-urgent
50
Q

What is cataracts?

A

cloudiness of the lens

51
Q

What are some of the causes of cataracts?

A

age related; congenital; traumatic; diabetes; steroid

52
Q

What is the treatmnet for cataracts?

A

surgical removal with intra-ocular lens implant if patient is symptomatic

53
Q

What are the signs of dry ARMD?

A

gradual decline in vision; central vision missing (scotoma); drusen- build up of waste products below RPE; atropjic patches of retina

54
Q

What is the treatment for dry ARMD?

A

supportive with vision aids

55
Q

What is a refractive error?

A

eye cannot clearly focus image

56
Q

What is myopia?

A

short sighted

57
Q

What is hypermetropia?

A

long sighted

58
Q

What is astigmatism?

A

irregular corneal curvature

59
Q

What is presbyopia?

A

loss of accomodation with aging

60
Q

What is glaucoma?

A

progressive optic neuropathy

61
Q

What does glaucoma ultimately result in?

A

optic nerve damage and therefore visual loss

62
Q

What is closed angle glaucoma?

A

fluid builds up and iris is pushed forward, shutting off angle

63
Q

What is the presentation of closed angle glaucoma

A

painful, red eye/visual loss/ headache/ nausea/vomiting

64
Q

What is the only modifiable risk factor in glaucoma?

A

IOP

65
Q

What are the symptoms for closed-type glaucoma?

A

often none, optician may discover

66
Q

What are the signs of open angle glaucoma?

A

cupped disc; visual field defect

Ophthalmology (10 decks)

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