Visual loss and blindness Flashcards
What are causes of sudden visual loss?
Vascular aetiology Retinal detachment Age related macular degeneration Closed angle glaucoma Optic neuritis Stroke
What are types of vascular aetiology?
Occlusion of Retinal circulation
optic nerve head circulation
Haemorrhage from abnormal blood vessels and retinal tear
What are symptoms of Central Retinal Artery Occlusion?
Sudden visual loss
Painless
What are signs of Central Retinal Artery Occlusion?
RAPD - relative afferent pupil defect
Pale oedematous retina, thread like retinal vessels
How do you treat CRAO if the patient presents within 24 hours?
Ocular message
convert CRAO to BRAO
What are vascular managements of CRAO?
Carotid doppler - find the source of emboli
Assess and manage risk factors
Name two other varients of retinal artery occlusion
branch retinal artery occlusion
Amaurosis fugax
What are symptoms of transient crao? (Amaurosis fugax)
Transient painless visual loss
Like a curtain closing down
Lasts 5 mins with full recovery
What should be done with transient crao?
Immediate referral to TIA clinic
Aspirin
What are systemic causes of Central retinal vein occlusion?
Virchow’s Triad:
Artherosclerosis
Hypertension
Hyperviscosity
What are symptoms for CRVO?
Sudden visual loss
Moderate to severe visual loss
What are signs for CRVO?
Retinal haemorrhages
Dilated tortuous veins
Disc swelling and macular swelling
Can laser treatment help with CRVO?
Yes, to help prevent complications
What is a treatment can be used for CRVO?
Anti-VEGF
What is Ischaemic Optic Neuropathy?
Occlusion of optic nerve head circulation
What can cause ischaemia of optic nerve head?
Giant cell arthritis
Atherosclerosis
What are things regarding GCC?
Headache Jaw claudication Scalp tenderness Malaise High ESR, PV and CRP
What are symptoms of vitreous haemorrhage?
Loss of vision
floaters
What are signs of vitreous haemorrhage?
Loss of red reflex
How do you treat a vitreous haemorrhage?
Vitrectomy
What are retinal detachment symptoms?
Painless loss of vision
Sudden onset of flashes/floaters
What are signs of retinal detachment?
May have RAPD
may see a tear on ophthalmoscopy
How do you manage retinal detachment?
usually surgically
What are wet and dry ARMD?
wet = sudden dry = gradual
what happens in wet ARMD?
new blood vessels leak under the retina leading to scarring
What are symptoms of wet ARMD?
Rapid onset visual loss
Distortion (metamorphopsia)
What are signs of wet ARMD?
haemorrhage
exudate
Describe anti-VEGF treatment
Injected into vitreous cavity.
Stops new blood vessels growing
What is cataracts?
cloudiness of the lens
What is a Christmas tree cataract?
Polychromatic cataract
What is the management of cataracts?
Surgical removal with intra-ocular lens implant if patient is symptomatic
What are symptoms of dry ARMD?
Gradual decline in vision
Central vision ‘missing’ (scotoma)
What are signs of ARMD?
Drusen - build up of waste products below RPE
Atrophic patches of retina
What is refractive error?
Eye cannot clearly focus image
What is myopia?
Short sighted
What is hypermetropia?
long sited
What is astigmatism?
usually irregular corneal curvature
What is presbyopia?
loss of accomodation with aging
What is glaucoma?
Progressive optic neuropathy
Optic nerve damage
Is acute glaucoma an ophthalmic emergency?
Yes
How can you manage glaucoma?
Lower IOP with drops/oral medication to prevent blindness
What are signs of glaucoma?
Cupped disc
Visual field defect
IOP
