Visual loss and blindness

Question 1

What are causes of sudden visual loss?

Answer 1

Vascular aetiology
Retinal detachment
Age related macular degeneration 
Closed angle glaucoma
Optic neuritis
Stroke

Question 2

What are types of vascular aetiology?

Answer 2

Occlusion of Retinal circulation
optic nerve head circulation
Haemorrhage from abnormal blood vessels and retinal tear

Question 3

What are symptoms of Central Retinal Artery Occlusion?

Answer 3

Sudden visual loss

Painless

Question 4

What are signs of Central Retinal Artery Occlusion?

Answer 4

RAPD - relative afferent pupil defect

Pale oedematous retina, thread like retinal vessels

Question 5

How do you treat CRAO if the patient presents within 24 hours?

Answer 5

Ocular message

convert CRAO to BRAO

Question 6

What are vascular managements of CRAO?

Answer 6

Carotid doppler - find the source of emboli

Assess and manage risk factors

Question 7

Name two other varients of retinal artery occlusion

Answer 7

branch retinal artery occlusion

Amaurosis fugax

Question 8

What are symptoms of transient crao? (Amaurosis fugax)

Answer 8

Transient painless visual loss
Like a curtain closing down
Lasts 5 mins with full recovery

Question 9

What should be done with transient crao?

Answer 9

Immediate referral to TIA clinic

Aspirin

Question 10

What are systemic causes of Central retinal vein occlusion?

Answer 10

Virchow’s Triad:
Artherosclerosis
Hypertension
Hyperviscosity

Question 11

What are symptoms for CRVO?

Answer 11

Sudden visual loss

Moderate to severe visual loss

Question 12

What are signs for CRVO?

Answer 12

Retinal haemorrhages
Dilated tortuous veins
Disc swelling and macular swelling

Question 13

Can laser treatment help with CRVO?

Answer 13

Yes, to help prevent complications

Question 14

What is a treatment can be used for CRVO?

Answer 14

Anti-VEGF

Question 15

What is Ischaemic Optic Neuropathy?

Answer 15

Occlusion of optic nerve head circulation

Question 16

What can cause ischaemia of optic nerve head?

Answer 16

Giant cell arthritis

Atherosclerosis

Question 17

What are things regarding GCC?

Answer 17

Headache
Jaw claudication 
Scalp tenderness
Malaise
High ESR, PV and CRP

Question 18

What are symptoms of vitreous haemorrhage?

Answer 18

Loss of vision

floaters

Question 19

What are signs of vitreous haemorrhage?

Answer 19

Loss of red reflex

Question 20

How do you treat a vitreous haemorrhage?

Answer 20

Vitrectomy

Question 21

What are retinal detachment symptoms?

Answer 21

Painless loss of vision

Sudden onset of flashes/floaters

Question 22

What are signs of retinal detachment?

Answer 22

May have RAPD

may see a tear on ophthalmoscopy

Question 23

How do you manage retinal detachment?

Answer 23

usually surgically

Question 24

What are wet and dry ARMD?

Answer 24

wet = sudden
dry = gradual

Question 25

what happens in wet ARMD?

Answer 25

new blood vessels leak under the retina leading to scarring

Question 26

What are symptoms of wet ARMD?

Answer 26

Rapid onset visual loss | Distortion (metamorphopsia)

Question 27

What are signs of wet ARMD?

Answer 27

haemorrhage | exudate

Question 28

Describe anti-VEGF treatment

Answer 28

Injected into vitreous cavity. | Stops new blood vessels growing

Question 29

What is cataracts?

Answer 29

cloudiness of the lens

Question 30

What is a Christmas tree cataract?

Answer 30

Polychromatic cataract

Question 31

What is the management of cataracts?

Answer 31

Surgical removal with intra-ocular lens implant if patient is symptomatic

Question 32

What are symptoms of dry ARMD?

Answer 32

Gradual decline in vision | Central vision 'missing' (scotoma)

Question 33

What are signs of ARMD?

Answer 33

Drusen - build up of waste products below RPE | Atrophic patches of retina

Question 34

What is refractive error?

Answer 34

Eye cannot clearly focus image

Question 35

What is myopia?

Answer 35

Short sighted

Question 36

What is hypermetropia?

Answer 36

long sited

Question 37

What is astigmatism?

Answer 37

usually irregular corneal curvature

Question 38

What is presbyopia?

Answer 38

loss of accomodation with aging

Question 39

What is glaucoma?

Answer 39

Progressive optic neuropathy | Optic nerve damage

Question 40

Is acute glaucoma an ophthalmic emergency?

Answer 40

Yes

Question 41

How can you manage glaucoma?

Answer 41

Lower IOP with drops/oral medication to prevent blindness

Question 42

What are signs of glaucoma?

Answer 42

Cupped disc Visual field defect IOP