Visual Loss Flashcards
causes of sudden visual loss?
vascular vitreous haemorrhage retinal detachment macular degeneration (age) closed angle glaucoma
is a vascular problem likely to cause sudden or gradual vision loss
sudden
main blood supply of the eye?
branches of the opthalmic artery
name 2 ways in which a vascular problem can present in the eye?
occlusion
haemorrhage
what vessel occlusions can cause sudden visual loss
central retinal artery
optic nerve head circulation
what vessel haemorrhaes can cause sudden visual loss?
abnormal blood vessels eg diabetes
retinal tear
how much of the retina is supplied by the central retinal artery?
inner 2/3
what is the blood supply to the outer 1/3rd of the retina
choroid
symptoms of a central retinal artery occlusion?
sudden visual loss
painless
signs of CRAO on examination?
relative afferent pupil defect
pale oedematous retina, thread like vessels
main cause of CRAO?
carotid artery disease
opthalmic management of CRAO?
ocular massage if it presents within 24hrs
vascular management of CRAO?
doppler to find source
manage and assess risk factors
what eye occlusion presents with a “curtain coming down” over the eye?
transient CRAO
how long does transient CRAO last for?
5 mins
signs of transient CRAO on exam?
usually nothing
Tx of TRAO?
aspirin
refer to stroke clinic
list the components of virchow’s triad?
atherosclerosis
hypertension
hyperviscosity
what kind of eye problem can an issue with virchow’s triad cause?
CRVO
how severe and sudden is the onset of visual loss in CRVO?
moderate to severe loss
very sudden
signs of CRVO on fundoscopy?
retinal haemorrhages
dilated tortuous veins
disc and macular swelling
Tx for CRVO?
monitor
anti-VEGF
lifestyle change
main cause of sudden visual loss in arteries?
embolism
main cause of sudden visual loss in veins?
stasis
what artery other than the central retinal artery can cause sudden visual loss when occluded?
branch retinal artery
does an arterial or venous occlusion look pale on fundoscopy?
arterial
2 sources of haemorrhage in the eye?
abnormal blood vessels
retinal tear
another phrase for occlusion of the optic nerve head circulation?
ischaemic optic neuropathy
what vessels become infarcted to cause ischaemic optic neuropathy?
posterior ciliary arteries
sudden, profound vision loss with a swollen disc?
ischaemic optic neuropathy
name the 2 types of ION and what causes them?
arteritic- GCA
non-arteritic- atherosclerosis
what does the disc look like in ION?
pale and swollen
ION is irreversible T or F
T
Tx for ION caused by GCA?
immediate high dose systemic steroid
where does a haemorrhage often go into in the eye?
vitreous cavity
bleeding from a retinal tear occurs from new vessels: T or F
F, comes from normal vessels
bleeding from a retinal vein occlusion occurs from new vessels T or F?
T
symptoms of vitreous haemorrhage?
loss of vision
floaters
what condition presents with loss of red reflex?
vitreous haemorrhage
Tx for vitreous haemorrhage?
vitrectomy
loss of vision in retinal detachment is painful T or F?
F
symptoms of retinal detachment?
painless loss of vision
flashes
floaters
do you get relative afferent pupillary defects in retinal detachments?
yes
what is ARMD?
age related macular degeneration
symptoms of wet ARMD?
rapid central visual loss
distorsion
signs of wet ARMD on fundoscopy?
haemorrhage
exudate
Tx of wet ARMD?
anti-VEGF treatment
another word for progressive optic neuropathy
glaucoma
how can glaucoma cause visual loss?
can get optic nerve damage
presentation of closed angle glaucoma
painful red eye visual loss headache nausea vomiting
cause of closed angle glaucoma?
aqueous humour faces resistance causing increased intraocular pressure
does gradual visual loss usually occur bilaterally or unilaterally?
bilaterally
causes of gradual visual loss?
cataract ARMD refractive error glaucoma diabetic retinopathy
“cloudiness of the lens” is experienced in what?
cataract
why should you check red reflex in neonates?
intrauterine infection can cause congenital cataract
what type of cataract is referred to as “christmas tree cataract”?
polychromatic cataract
cataract symptoms?
gradual decline in vision
glare
treatment of cataract?
surgical removal with intraocular lens implant if patient is symptomatic
difference between dry and wet macular degeneration?
dry= gradual reduction in vision wet= sudden reduction in vision
what part of the vision is missing in dry ARMD?
central vision
symptoms of dry ARMD?
gradual decline in vision
central vision missing
what is drusens sign?
build up of waste products below RPE
appearance of dry ARMD on fundoscopy?
atrophic patches of retina
Tx of dry ARMD?
no cure; supportive
what is a refractive error?
eye cannot focus on an image clearly
what is myopia?
short sightedness
what is hypermetropia?
long sightedness
what is astigmatism?
irregular corneal curvature
what is presbyopia?
loss of accommodation with aging
what type of glaucoma can present with no symptoms?
open angle
signs of glaucoma on fundoscopy?
cupped disc
visual field defect
high IOP
Tx of open angle glaucoma?
eye drops
laser
surgery
to preserve vision
