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OPHTHALMOLOGY > Visual Loss and Blindness > Flashcards

Visual Loss and Blindness Flashcards

1
Q

What vascular problems can cause sudden visual loss?

A
  • Occlusion of either retinal or optic nerve circulation

- Haemorrhage

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2
Q

What symptoms present when the central artery of the retina is occluded?

A

Sudden visual loss with no PAIN

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3
Q

What signs can show a central retinal artery occlusion

A
  • RAPD (relative afferent pupil defect - slight dilatation)
  • Pale oedematous retina
  • thread-like retinal vessels
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4
Q

Emboli from where can cause Central Retinal Artery Occlusions (CRAO)?

A
  • Carotid artery disease
  • Emboli from the heart (unusual)

**type of stroke

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5
Q

Occlusion of a branch of the retinal artery can cause what?

A

Amaurosis fugax - transient occlusion

“curtain coming down”

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6
Q

What symptoms present in an occlusion of a branch of the retinal artery?

A
  • transient painless visual loss
  • ‘like a curtain coming down’
  • lasts around 5mins with full recovery
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7
Q

Any transient CRAO requires urgent referral to the stroke clinic. TRUE/FALSE?

A

TRUE

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8
Q

How is a central retinal vein occlusion commonly caused?

A

Endothelial damage e.g. diabetes
Abnormal blood flow e.g. hypertension
Hypercoaguable state e.g. cancer

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9
Q

A central retinal vein occlusion presents with variable sudden vision loss. TRUE/FALSE?

A

TRUE

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10
Q

What signs are present on fundoscopy when there has been a central retinal vein occlusion?

A
  • Retinal haemorrhages
  • Dilated tortuous veins
  • Disc and macular swelling
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11
Q

Describe the main difference on fundoscopy for CRAO and CRVO?

A 
CRAO = pale with thin vessels
CRVO = dark with tortuous vessels
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12
Q

Infarction of the head of the optic nerve is caused by an occlusion in which artery?

A

Posterior ciliary arteries

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13
Q

Infarction of the optic nerve head is known as what condition?

A

Ischaemic optic neuropathy

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14
Q

What other condition can cause ischaemic optic neuropathy?

A

Giant Cell/ Temporal Arteritis

causes lumen of posterior ciliary arteries to become occluded

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15
Q

The sudden visual loss caused in ischaemic optic neuropathy is irreversible. TRUE/FALSE?

A

TRUE

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16
Q

What other symptoms may be present in giant cell arteritis?

A
  • Headache (usually temporal)
  • Jaw claudication
  • Scalp tenderness (painful to comb hair)
  • Tender/enlarged scalp arteries
  • Amaurosis fugax
  • Malaise
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17
Q

Why do abnormal vessels haemorrhage into the vitreous cavity?

A

Retinal ischaemia in diabetes OR retinal vein occlusion => abnormal, fragile new blood vessels form and leak

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18
Q

When would normal blood vessels haemorrhage into the vitreous cavity?

A

When bridging a retinal tear

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19
Q

What symptoms and signs indicate a vitreous haemorrhage

A
  • Loss of vision
  • ‘Floaters
  • Loss of red reflex
20
Q

What are the common symptoms of retinal detachment

A
  • Painless loss of vision

- Sudden onset of flashes/floaters (mechanical - separation of sensory retina from retinal pigment epithelium)

21
Q

How does a detached retina appear on fundoscopy

A

pale
curled up
oedematous

22
Q

What type or age related macular degeneration can cause sudden visual loss?

A

Wet

dry type causes gradual sight loss

23
Q

Describe the pathogenesis of wet ARMD

A
  • New blood vessels grow under retina
  • Leakage causes build up of fluid/blood
  • eventually scarring develops
24
Q

What symptoms do patients with wet ARMD experience?

A
  • Rapid central visual loss

- Distortion (metamorphopsia)

25
Q

What can be seen on a fundoscopy when a patient has wet ARMD?

A
  • haemorrhage

- exudate

26
Q

What type of glaucoma is responsible for sudden visual loss?

A

Closed-angle glaucoma

27
Q

What symptoms are experienced in closed-angle glaucoma?

A
  • painful, red eye
  • sudden visual loss
  • headache
  • nausea/vomiting
28
Q

What signs can be seen in closed-angle glaucoma?

A
  • red eye
  • cloudy cornea
  • dilated pupil (cant move due to optic nerve ischaemia)
29
Q

What are the main differences between sudden and gradual visual loss?

A

Bilateral

Often asymmetrical

30
Q

How does gradual visual loss present early vs late?

A

Presents early with reduced Visual Acuity

May present late with decreased field

31
Q

What are the main causes of gradual visual loss?

A
  • Cataract
  • Age related macular degeneration (dry type)
  • Refractive error
  • Glaucoma
  • Diabetic retinopathy
32
Q

Describe the pathogenesis of lens clouding in cataracts

A

abnormal changes in lens proteins (crystallins)
=> changes their structure
=> leading to loss of transparency

33
Q

What are the main causes of cataracts?

A
  • age related
  • congenital (intrauterine infection)
  • traumatic
  • metabolic (diabetes)
  • drug-induced (steroids)
34
Q

What visual symptoms may patients with cataracts experience?

A
  • decline in vision (‘hazy’ / ‘blurred’) that cannot be corrected with glasses
  • May get glare from sunshine
35
Q

What surgery is used for cataracts and is it always useD?

A

intra-ocular lens implant

only completed if patient is symptomatic

36
Q

What part of the vision is lost in dry type ARMD?

A

Central vision ‘missing’ (scotoma)

37
Q

What signs can be seen on fundoscopy that indicate dry type ARMD?

A
  • Drusen – build up of waste

- Atrophic patches of retina

38
Q

Explain the role of magnifiers in dry type ARMD

A

Scotoma stays in same place

=> magnifier allows font or object to get larger and more to be viewed around missing part of vision

39
Q

What is required if patients have a refractive error?

A

Glasses

40
Q

What is the correct term for “short-sighted”?

A

Myopia

41
Q

What is the correct term for “long-sighted”?

A

Hypermetropia

42
Q

What is an astigmatism?

A

irregular corneal curvature

43
Q

Older patients can lose the ability to accommodate, what is this called?

A

Presbyopia

44
Q

Patients with open-angle glaucoma often have no symptoms. TRUE/FALSE?

A

TRUE

picked up by optometrist

45
Q

What signs can open-angle glaucoma cause?

A

Cupped disc
Visual field defect
High Intra-ocular pressure

OPHTHALMOLOGY (12 decks)

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