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Surg Spec (Ophthalmology) > Visual Loss > Flashcards

Visual Loss Flashcards

1
Q

What is the most common type of cataract?

A

Nuclear

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2
Q

What type of cataract is caused by steroid use?

A

Subcapsular

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3
Q

Which pathology typically presents with a gradual decline in vision which cannot be corrected with glasses, as well as problems with glare, faded colour vision and halos around lights?

A

Cataract

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4
Q

What is the main feature that will be seen on examination of someone with a cataract?

A

Absence of or reduced red reflex

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5
Q

How are cataracts treated?

A

Phaco-emulsification with intra-ocular lens implantation

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6
Q

After cataract surgery, patients should be given which eye drops 4x daily for 1 month?

A

Chloramphenicol and prednisolone 1%

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7
Q

What is the commonest cause of blindness in the western world in > 65s?

A

ARMD

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8
Q

Any macular problem typically leads to the formation of what symptoms?

A

Central scotoma, blurred vision and metamorphopsia

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9
Q

The development of what feature in individuals with dry ARMD can indicate progression from dry to wet form and requires urgent opthalmological assessment?

A

Metamorphopsia

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10
Q

What are the main risk factors for ARMD?

A

Increasing age, family history and smoking

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11
Q

What is the main feature of dry ARMD seen on fundoscopy?

A

Drusen

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12
Q

Which pathology typically presents with a slow, progressive drop in central visual actuity?

A

Dry ARMD

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13
Q

There is currently no active treatment for dry ARMD, what is some advice that is given to patients?

A

Smoking cessation, eat more green leafy veg, blind registration and use of visual aids

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14
Q

Which pathology typically presents with a fairly sudden devastating drop in central visual acuity and associated metamorphopsia?

A

Wet ARMD

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15
Q

What investigation is used for identification and monitoring of wet ARMD?

A

Ocular coherence tomography (OCT)

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16
Q

How is wet ARMD treated?

A

Intra-vitreal anti-VEGF injections

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17
Q

What is the commonest cause of treatable blindness in the working age population?

A

Diabetic retinopathy

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18
Q

What are the 3 main categories of diabetic retinopathy?

A

No retinopathy, non-proliferative retinopathy (mild/moderate/severe), proliferative retinopathy

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19
Q

How are patients with no retinopathy or mild non-proliferative retinopathy treated?

A

Screen again in 12 months

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20
Q

How are patients with moderate non-proliferative retinopathy treated?

A

Screen again in 6 months

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21
Q

How are patients with severe non-proliferative retinopathy treated?

A

Referral to ophthalmology

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22
Q

How are patients with proliferative retinopathy treated?

A

Urgent referral to ophthalmology

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23
Q

What is the definitive treatment for any symptomatic non-proliferative retinopathy and any proliferative retinopathy?

A

Laser treatment

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24
Q

Diabetic maculopathy should only be treated when there is reduced vision. What treatment is used?

A

Anti-VEGF and sometimes focal laser treatment

25
Q

When must the DVLA be informed of an individual undergoing laser eye treatment?

A

If the individual has undergone laser eye treatment in both eyes

26
Q

What features on fundoscopy classify mild non-proliferative diabetic retinopathy?

A

1 or more microaneurysm

27
Q

What features on fundoscopy classify moderate non-proliferative diabetic retinopathy?

A

Microaneurysms, blot haemorrhages, hard exudates, cotton wool spots

28
Q

For non-proliferative diabetic retinopathy to be classified as severe, there must be blot haemorrhages and microaneurysms in how many quadrants?

A

All 4

29
Q

For non-proliferative diabetic retinopathy to be classified as severe, there must be venous beading in how many quadrants?

A

At least 2

30
Q

For non-proliferative diabetic retinopathy to be classified as severe, there must be intraretinal microvascular abnormalities (IRMA) in how many quadrants?

A

At least 1

31
Q

What is the main feature of proliferative diabetic retinopathy?

A

Retinal neovascularisation

32
Q

Retinal neovascularisation seen in proliferative diabetic retinopathy can lead to what complication?

A

Vitreous haemorrhage

33
Q

Proliferative diabetic retinopathy is most commonly seen in individuals with which type of diabetes?

A

Type 1

34
Q

Diabetic maculopathy is most common in individuals with which type of diabetes?

A

Type 2

35
Q

Silver wiring is a feature seen on fundoscopy of which pathology?

A

Hypertensive retinopathy (stage I)

36
Q

Cotton wool exudates and flame and blot haemorrhages are features of which stage of hypertensive retinopathy?

A

Stage III

37
Q

What is the feature suggestive of stage IV hypertensive retinopathy?

A

Papilloedema

38
Q

What is the main feature of glaucoma on fundoscopy?

A

Increased cup to disc ratio

39
Q

What are the 4 different pharmacological treatment options that can be used for chronic open angle glaucoma?

A

Prostaglandins, beta blockers, carbonic anhydrase inhibitors, parasympathomimetics

40
Q

What is the definitive surgical management for chronic open angle glaucoma?

A

Trabeculectomy

41
Q

Which pathology typically presents with a sudden, profound, painless visual loss and a relative afferent pupillary defect?

A

Central retinal artery occlusion

42
Q

Which pathology will cause a pale, swollen retina with a cherry red spot at the macula?

A

Central retinal artery occlusion

43
Q

Methods to try and dislodge the clot can be used if an individual with a CRAO presents within what timeframe?

A

90 minutes

44
Q

Which pathology presents with a transient painless visual loss ‘like a curtain coming down’, which lasts around 5 minutes with a full recovery?

A

Amourosis fugax (transient CRAO)

45
Q

Which pathology presents with a moderate-severe visual loss and relative afferent pupillary defect?

A

Central retinal vein occlusion

46
Q

Which pathology will show retinal flame haemorrhages and torturous vessels on fundoscopy?

A

Central retinal vein occlusion

47
Q

Which pathology is more commonly seen in diabetics, those with bleeding disorders or those taking anti-coagulants and presents with a loss of vision and the presence of floaters?

A

Vitreous haemorrhage

48
Q

Which pathology presents with flashers, floaters and a dark shadow in the peripheral vision which is increasing in size?

A

Retinal detachment

49
Q

Is retinal detachment more common in those who are short sighted or long sighted?

A

Short sighted (myopic)

50
Q

Which pathology results in a variable loss of vision, usually over a few days, washed out colours (red desaturation) and a dull ache behind the eye on movements?

A

Optic neuritis

51
Q

Most cases of optic neuritis will resolve spontaneously within how long?

A

4 weeks

52
Q

Is acute angle closure glaucoma more common in those who are short sighted or long sighted?

A

Long sighted (hypermetropic)

53
Q

Which pathology presents with severely reduced visual acuity, pain +/- nausea/vomiting?

A

Acute angle closure glaucoma

54
Q

Which pathology causes a red eye, cloudy/hazy cornea, fixed mid-dilated pupil?

A

Acute angle closure glaucoma

55
Q

What is the first, non-pharmacological treatment that can be done for acute angle closure glaucoma?

A

Lie the patient flat

56
Q

What topical drops are given to patients with acute angle closure glaucoma?

A

Anti-hypertensives, steroids and pilocarpine

57
Q

What IV treatment can be given to patients with acute angle closure glaucoma?

A

Acetazolamide

58
Q

What is the definitive treatment for acute angle closure glaucoma?

A

YAP laser peripheral iridotomy

Surg Spec (Ophthalmology) (3 decks)

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