Visual Loss and Blindness Flashcards
What are causes of sudden visual loss?
CRAO CRVO Ischaemic Retinal detachment Wet ARMD Closed angle glaucoma Optic neuritis
What is CRAO?
Central retinal artery occlusion
Like a stroke of the eye
Embolic cause
What are the causes of CRAO/
Carotid artery disease
Emboli from heart
What are the symptoms of CRAO?
Painless
Sudden visual loss
Profound visual loss
What constitutes as profound visual loss?
Counting fingers or less
What are the signs in CRAO?
Relevant afferent pupiliary defect
Pale retina
Oedematous retina
Thread like vessels
What is RAPD?
Pupil dilates on light source
How do you manage CRAO?
Ophthalmic massage to turn from CRAO to BRAO
Carotid doppler for source and risk factors
What are the symptoms of amaurosis fugax?
Transient visual loss
Painless
‘like curtain coming down’
What are the signs of amaurosis fugax?
Normal
How do you manage amaurosis fugax?
Refer to TIA clinic
Aspirin
What is CRVO?
Central retinal vein occlusion
Raised IOP causes STASIS
Virchow’s triad
What are the symptoms of CRVO?
Sudden visual loss
Moderate to sever visual loss 6/9 and PoL
Painless
What are the signs of CRVO?
Dark retina Retinal haemorrhage Dilated veins Disc swelling Macular swelling
How can you CRVO?
Treat underlying cause
Monitor for new vessels
Anti-VEGF injections
Laser therapy
What causes non arteritic ischaemic optic neuropathy?
Athersclerosis
What are the symptoms and signs in non arteritic ischameic optic neuropathy?
Sudden profound visual loss
Swollen disc
What is the aetiology of giant cell arteritis?
Mid-large size arteries inflamed
Lumen occluded in posterior cilliary arteries
optic nerve head ischaemia
Visual loss
What do giant cells look like?
Multi nucleate cells
What are the symptoms of giant cell arteritis?
Sudden Visual loss Profound visual loss Headache Jaw claudication painful scalp Enlarged temporal arteries Amaurosis fugax Malaise
What are the signs in giant cell arteritis?
Pale disc
Swollen disc
What investigations can be done in giant cell arteritis?
CRP
ESR
PV
Biopy or temporal arteries
Why may biopsy appear normal in giant cell arteritis?
Skip lesions
need a few samples
What happens in retinal detachment?
Mechanical separation of retina from choroid
What are the symptoms of retinal detachment?
Sudden visual loss
Flashes
Floaters
What are the signs of retinal detachment?
RAPD
tear on ophthalmoscopy
What is the management of retinal detachment?
Surgical reattachment
What happens in vitreous haemorrhage?
Ischaemia
New vessels growth (weak)
New vessels tear
Causes haemorrage
What are the symptoms of vitreous haemorrhage?
Sudden visual loss
Floaters
What are the signs of vitreous haemorrhage?
Loss of red reflex
No RAPD
How do you manage vitreous haemorrhage?
Vitrectomy
What is the aetiology of wet ARMD?
New blood vessels grow under retina
Leakage of weak vessels
Fluid builds up under retina
Can cause scarring
What are the symptoms of wet ARMD?
Sudden CENTRAL visual loss
Distortion (metamorphopsia)
What are the signs of wet ARMD?
Heamorrhage
Exudate
How do you treat wet ARMD?
anti-VEGF
Laser
photodynamic therapy
What are the gradual causes of visual loss?
Cataract
Dry ARMD
Open angle glaucoma
Refractive errors
What are the causes of cataracts?
Age Congenital Trauma Metabolic (diabetes) Steroids
What causes congenital cataracts in neonates?
Chlamydia infection intrauterine
What types of cataracts are there?
Nuclear
Posterior sub capsular
Christmas tree (polychromatic)
Congenital
What are the symptoms of cataracts?
Painless
Floaters
Gradual visual loss
What is the management of cataracts?
Removal of intraocular lens
What are the symptoms of dry ARMD?
Gradual visual loss
Central visual loss
What are the signs of dry ARMD?
Drusen
Retinal pigment epithelial changes
Atrophy
Hyperplasia
What is the management of dry ARMD?
Magnifiers
What is the aetiology of open angle glaucoma?
Small drainage angle Increase aqueous Increase IOP Damage to retinal nerve fibres Visual field contracts
What are the symptoms of open angle glaucoma
None!
What are the signs of open angle glaucoma?
increased IOP
cupping
visual field defect
What is the treatment for open angle glaucoma?
Pressure reducing eye drops
Trabeculotomy
What is hypermetropia
Long sightedness
What make the eye hypermetropic
Eye too small
What does hypermetropia increase your risk of?
Glaucoma
What is Myopia?
Short sightedness
What make the eye myopic?
Eye too big
What is Astigmatism?
Irregular corneal curvature
What is presbyopia
Loss of accommodation
What makes the eye presbyopic?
Lens thickens with age
What is the treatment for a refractive error?
Glasses
