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ophthalmology > visual loss and blindness > Flashcards

visual loss and blindness Flashcards

1
Q

what is the major blood supply to the eye?

A

opthalmic artery

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2
Q

what are the symptoms of central retinal artery occlusion?

A

sudden painless vision loss
RAPD (relative afferent pupil defect)
pale oedmatous retina

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3
Q

what causes central retinal artery occlusion (type of stroke)?

A

carotid artery disease usually

rarely heart emboli or giant cell arteritis

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4
Q

what would you see in a branch retinal artery occlusion?

A

partially pale retina

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5
Q

what is amaurosis fugax?

A

transient CRAO

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6
Q

what are the symptoms of amaurosis fugax (transient CRAO)?

A

transient painless visual loss
‘like a curtain coming down’
lasts~5mins with full recovery

usually normal examination
refer to stroke clinic

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7
Q

what is central retinal vein occlusion associated with?

A

virchow’s triad
Endothelial damage e.g. diabetes
Abnormal blood flow e.g. hypertension
Hypercoaguable state e.g. cancer

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8
Q

what are the signs and symptoms of central retinal vein occlusion?

A

sudden vision loss
Retinal haemorrhages
Dilated tortuous veins
Disc swelling and macular swelling
cotton wool spots

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9
Q

what is ischaemic optic neuropathy (ION)?

A

occlusion of optic nerve head circulation
posterior ciliary arteries become occluded, resulting in infarction of the optic nerve head

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10
Q

what are the signs and symptoms of ischaemic optic neuropathy?

A

sudden painless vision loss
swollen optic nerve

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11
Q

what happens in vitreous haemorrhage?

A

Bleeding can either occur from abnormal vessels e.g. retinal ischaemia in diabetes or retinal vein occlusion causes abnormal, fragile new blood vessels to form
or
normal retinal vessels e.g. bridging a retinal tear

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12
Q

what are the signs and symptoms of vitreous haemorrhage?

A

vision loss
floaters
loss of red reflex
may see haemorrhage on fundoscopy

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13
Q

what are the signs and symptoms of retinal detachment?

A

Painless loss of vision
Sudden onset of flashes/floaters (mechanical separation of sensory retina from retinal pigment epithelium)
may have RAPD
may see tear on opthalmoscopy

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14
Q

what are the 2 types of age related macular degeneration?

A

wet (sudden vision loss)
dry (gradual vision loss)

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15
Q

what causes wet age related macular degeneration?

A

New blood vessels grow under retina – leakage causes build up of fluid/blood and eventually scarring

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16
Q

what are the signs and symptoms of wet age related macular degeneration?

A

rapid central vision loss
distortion
haemorrhage / exudate

17
Q

what causes glaucoma?

A

progressive optic neuropathy ultimately resulting in optic nerve damage causing vision loss

18
Q

what causes closed-angle galucoma?

A

Aqueous humour encounters increased resistance through iris/lens channel

Increased pressure gradient causes peripheral iris to bow forward, obstructing trabecular meshwork – pressure increases

May be acute (ophthalmic emergency)

19
Q

what are the signs and symptoms of acute (closed angle) glaucoma?

A

painful, red eye
sudden vision loss
headache
nausea & vomiting
cloudy cornea & dilated pupil

20
Q

what is the treatment of acute (closed-angle) glaucoma?

A

lowering IOP with drops / oral medication to prevent blindness

21
Q

what is cataract?

A

Cloudiness of the lens- abnormal changes in lens proteins (crystallins) result in their chemical and structural alteration, leading to loss of transparency

22
Q

what are the main causes of cataract?

A

age-related, congenital, metabolic, drug induced (steroids), intrauterine infection

23
Q

what are the different types of cataract?

A

nuclear cataract
posterior subcapsular cataract
christmas tree (polychromatic) cataract
congenital catract

24
Q

what are the symptoms of cataract?

A

gradual hazy / blurred vision loss

25
Q

what is the management of cataract?

A

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

26
Q

what are the signs and symptoms of dry age related macular degeneration (dry ARMD)?

A

gradual decline in vision
central vision missing (scotoma)
drusen (buildup of waste products below RPE)
atrophic patch of retina

27
Q

what is the treatment of dry ARMD?

A

no cure - supportive treatment with low vision aids

28
Q

what are the signs and symptoms of open-angle glaucoma?

A

usually no symptoms
cupped disc = loss of retinal ganglion cells
visual filed defect
may have high IOP

29
Q

does a bigger optic cup indicate more or less damage from glaucoma?

A

more

big cup (thinner rim) = more damage

ophthalmology (12 decks)

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