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Ophthalmology > Visual loss and blindness > Flashcards

Visual loss and blindness Flashcards

1
Q

What are the 7 causes of sudden visual loss?

A
  1. Vascular aetiology (retinal artery/vein occlusion)
  2. Vitreous haemorrhage
  3. Retinal detachment
  4. Wet ARMD
  5. Closed angle glaucoma
  6. optic neuritis
  7. Stroke
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2
Q

Describe the arterial supply of the eye

A

Internal carotid artery gives off branches, ophthalmic artery is the main supply to the eye

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3
Q

What are the branches of the ophthalmic artery?

A

Posterior ciliary, supply the optic nerve head

Central retinal artery, supply inner 2/3rds of retina

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4
Q

What are the symptoms of central retinal artery/vein occlusion ?

A

Sudden visual loss

Painless

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5
Q

What are the signs of central retinal artery occlusion?

A

RAPD

Pale oedematous retina

Thready retinal vessels

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6
Q

Describe branch retinal artery occlusion

A

Only part of retina will look pale

Half of visual field compromised

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7
Q

Describe amaurosis fugax symptoms?

A

Transient painless visual loss

Lasts 5 minutes with full recovery

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8
Q

When can haemorrhages occur in the eye?

A

Abnormal blood vessels- wet ARMD, diabetes

Normal vessels -Bridging a retinal tear

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9
Q

What are the causes of central retinal vein occlusion?

A

Carotid artery disease

Emboli from heart- endocarditis?

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10
Q

What are the signs of a central retinal vein occlusion?

A
  • retinal haemorrhages
  • dilated torturous veins
  • disc swelling and macular swelling
  • edge of disc may be swollen
  • cotton wool spots
  • oedematous macula
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11
Q

What is ischaemic optic neuropathy?

A

Posterior ciliary arteries become occluded, infarction of optic nerve head

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12
Q

What can cause ischaemic optic neuropathy?

A

GCA

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13
Q

What are the symptoms of ischaemic optic neuropathy?

A

Sudden visual loss

Irreversible blindness

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14
Q

What are the signs of ischamic optic neuropathy?

A

Swollen optic nerve

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15
Q

Describe symptoms of a vitreous haemorrhage

A

Loss of vision

Floaters- flu, cobwebs, black dot

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16
Q

What are the signs of a vitreous haemorrhage?

A

Loss of red reflex
-media not clear, may look black, brown

May see haemorrhage on fundoscopy

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17
Q

What is important in vitreous haemorrhage?

A

Fina a cause

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18
Q

What are the symptoms of retinal detachment?

A

Painless loss of vision

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

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19
Q

What are the signs of retinal detachment?

A

RAPD

20
Q

What can cause retinal detachment?

A

Age makes vitreous more liquidy- this can pull on retina and tear it

21
Q

What are the factors related to ARMD?

A

Smoking, FHx, poor nutrition

22
Q

Describe wet ARMD?

A

New blood vessels grow under retina from the choroid, leakage causes build up of fluid/blood and eventually scarring

23
Q

What are the symptoms of wet ARMD?

A

Rapid central visual loss

Distortion (metamorphosia- straight lines may appear linked)

24
Q

What are the signs of wet ARMD?

A

Haemorrhages/exudate (protein leaked and precipitated into retina)

25
Q

What is the amsler test?

A

Grid- cover up one eye and describe what you see

26
Q

What are the symptoms of dry ARMD?

A

Gradual visual loss

27
Q

What is the only modifiable risk factor in glaucoma?

A

High IOP

28
Q

Describe closed angle glaucoma?

A
  • aqueous humour encounters increased resistance through iris/lens channel
  • increased pressure gradient causes peripheral iris to bow forward, obstructing trabecular meshwork- pressure increases
  • may be acute (ophthalmic emergency)
29
Q

Describe the symptoms of acute closed angle glaucoma?

A

Painful, red eye/sudden visual loss/headache/nausea/vomitting

30
Q

Describe the signs of acute closed angle glaucoma?

A

Red eye, cloudy cornea, dilated pupil

31
Q

What causes pupil dilation in acute closed angle glaucoma?

A

Ischaemia has rendered it non-functional

32
Q

What are the common causes of gradual visual loss?

A 
Cataracts
Dry ARMD
Refractive error
Open angle glaucoma
Diabetic retinopathy
33
Q

Describe cataracts?

A

Cloudiness of the lens- abnormal changes in lens proteins (crystalline) result in their chemical and structural alteration, leading to loss of transparency

34
Q

What are the causes of cataracts?

A 
Age
Congenital e.g. Intra-uterine infection 
Traumatic
Metabolic (diabetes)
Drug induced
35
Q

What are the 4 types of cataract?

A

Nuclear cataract

Posterior subcapsular cataract

Polychromatic cataract

Congenital cataract

36
Q

Which type of cataract is particularly visually disabling?

A

Posterior sub capsular cataract

37
Q

Describe a congenital cataract?

A

Dense centre- no brown/green colour

38
Q

What are the symptoms of cataract?

A

Gradual decline in vision (hazy/blurred) that cannot be corrected

Glare (at night when driving)

39
Q

Describe dry ARMD?

A

Build up of drusen inner retina (by-products of epithelial cells) stops nutrition diffusing to retina from choroid.
The retina gets further away from nutrition and thins

40
Q

What are the symptoms of dry ARMD?

A

Gradual decline in vision

Central vision missing (scotoma)

41
Q

What are the signs of dry ARMD?

A

Drusen= yellow-white flecks

Atrophic bathes of retina (appears bright red as you can see choroidal vessels)

42
Q

What is myopia?

A

Short-sightedness

43
Q

What is hypermetropia?

A

Long-sightedness

44
Q

What is astigmatism?

A

Irregular corneal curvature

45
Q

What is presbyopia?

A

loss of accommodation with ageing

46
Q

Describe open angle glaucoma?

A

Something stopping drainage through trabecular meshwork

47
Q

What are the signs of closed angle glaucoma?

A

Cupped disc
Visual field defect (Arcuate)
May/may not have high IOP

Ophthalmology (15 decks)

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