Visual Loss and Blindness

Question 1

What are causes of sudden visual loss?

Answer 1

CRAO 
CRVO
Ischaemic
Retinal detachment 
Wet ARMD
Closed angle glaucoma
Optic neuritis

Question 2

What is CRAO?

Answer 2

Central retinal artery occlusion
Like a stroke of the eye
Embolic cause

Question 3

What are the causes of CRAO/

Answer 3

Carotid artery disease

Emboli from heart

Question 4

What are the symptoms of CRAO?

Answer 4

Painless
Sudden visual loss
Profound visual loss

Question 5

What constitutes as profound visual loss?

Answer 5

Counting fingers or less

Question 6

What are the signs in CRAO?

Answer 6

Relevant afferent pupiliary defect
Pale retina
Oedematous retina
Thread like vessels

Question 7

What is RAPD?

Answer 7

Pupil dilates on light source

Question 8

How do you manage CRAO?

Answer 8

Ophthalmic massage to turn from CRAO to BRAO

Carotid doppler for source and risk factors

Question 9

What are the symptoms of amaurosis fugax?

Answer 9

Transient visual loss
Painless
‘like curtain coming down’

Question 10

What are the signs of amaurosis fugax?

Answer 10

Normal

Question 11

How do you manage amaurosis fugax?

Answer 11

Refer to TIA clinic

Aspirin

Question 12

What is CRVO?

Answer 12

Central retinal vein occlusion
Raised IOP causes STASIS
Virchow’s triad

Question 13

What are the symptoms of CRVO?

Answer 13

Sudden visual loss
Moderate to sever visual loss 6/9 and PoL
Painless

Question 14

What are the signs of CRVO?

Answer 14

Dark retina
Retinal haemorrhage 
Dilated veins
Disc swelling
Macular swelling

Question 15

How can you CRVO?

Answer 15

Treat underlying cause
Monitor for new vessels
Anti-VEGF injections
Laser therapy

Question 16

What causes non arteritic ischaemic optic neuropathy?

Answer 16

Athersclerosis

Question 17

What are the symptoms and signs in non arteritic ischameic optic neuropathy?

Answer 17

Sudden profound visual loss

Swollen disc

Question 18

What is the aetiology of giant cell arteritis?

Answer 18

Mid-large size arteries inflamed
Lumen occluded in posterior cilliary arteries
optic nerve head ischaemia
Visual loss

Question 19

What do giant cells look like?

Answer 19

Multi nucleate cells

Question 20

What are the symptoms of giant cell arteritis?

Answer 20

Sudden Visual loss
Profound visual loss
Headache
Jaw claudication
painful scalp
Enlarged temporal arteries
Amaurosis fugax 
Malaise

Question 21

What are the signs in giant cell arteritis?

Answer 21

Pale disc

Swollen disc

Question 22

What investigations can be done in giant cell arteritis?

Answer 22

CRP
ESR
PV
Biopy or temporal arteries

Question 23

Why may biopsy appear normal in giant cell arteritis?

Answer 23

Skip lesions

need a few samples

Question 24

What happens in retinal detachment?

Answer 24

Mechanical separation of retina from choroid

Question 25

What are the symptoms of retinal detachment?

Answer 25

Sudden visual loss Flashes Floaters

Question 26

What are the signs of retinal detachment?

Answer 26

RAPD | tear on ophthalmoscopy

Question 27

What is the management of retinal detachment?

Answer 27

Surgical reattachment

Question 28

What happens in vitreous haemorrhage?

Answer 28

Ischaemia New vessels growth (weak) New vessels tear Causes haemorrage

Question 29

What are the symptoms of vitreous haemorrhage?

Answer 29

Sudden visual loss | Floaters

Question 30

What are the signs of vitreous haemorrhage?

Answer 30

Loss of red reflex | No RAPD

Question 31

How do you manage vitreous haemorrhage?

Answer 31

Vitrectomy

Question 32

What is the aetiology of wet ARMD?

Answer 32

New blood vessels grow under retina Leakage of weak vessels Fluid builds up under retina Can cause scarring

Question 33

What are the symptoms of wet ARMD?

Answer 33

Sudden CENTRAL visual loss | Distortion (metamorphopsia)

Question 34

What are the signs of wet ARMD?

Answer 34

Heamorrhage | Exudate

Question 35

How do you treat wet ARMD?

Answer 35

anti-VEGF Laser photodynamic therapy

Question 36

What are the gradual causes of visual loss?

Answer 36

Cataract Dry ARMD Open angle glaucoma Refractive errors

Question 37

What are the causes of cataracts?

Answer 37

``` Age Congenital Trauma Metabolic (diabetes) Steroids ```

Question 38

What causes congenital cataracts in neonates?

Answer 38

Chlamydia infection intrauterine

Question 39

What types of cataracts are there?

Answer 39

Nuclear Posterior sub capsular Christmas tree (polychromatic) Congenital

Question 40

What are the symptoms of cataracts?

Answer 40

Painless Floaters Gradual visual loss

Question 41

What is the management of cataracts?

Answer 41

Removal of intraocular lens

Question 42

What are the symptoms of dry ARMD?

Answer 42

Gradual visual loss | Central visual loss

Question 43

What are the signs of dry ARMD?

Answer 43

Drusen Retinal pigment epithelial changes Atrophy Hyperplasia

Question 44

What is the management of dry ARMD?

Answer 44

Magnifiers

Question 45

What is the aetiology of open angle glaucoma?

Answer 45

``` Small drainage angle Increase aqueous Increase IOP Damage to retinal nerve fibres Visual field contracts ```

Question 46

What are the symptoms of open angle glaucoma

Answer 46

None!

Question 47

What are the signs of open angle glaucoma?

Answer 47

increased IOP cupping visual field defect

Question 48

What is the treatment for open angle glaucoma?

Answer 48

Pressure reducing eye drops | Trabeculotomy

Question 49

What is hypermetropia

Answer 49

Long sightedness

Question 50

What make the eye hypermetropic

Answer 50

Eye too small

Question 51

What does hypermetropia increase your risk of?

Answer 51

Glaucoma

Question 52

What is Myopia?

Answer 52

Short sightedness

Question 53

What make the eye myopic?

Answer 53

Eye too big

Question 54

What is Astigmatism?

Answer 54

Irregular corneal curvature

Question 55

What is presbyopia

Answer 55

Loss of accommodation

Question 56

What makes the eye presbyopic?

Answer 56

Lens thickens with age

Question 57

What is the treatment for a refractive error?

Answer 57

Glasses