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Ophthalmology > Visual Loss and Blindness > Flashcards

Visual Loss and Blindness Flashcards

1
Q

visual loss can be either ______ or gradual

A

visual loss can be either SUDDEN or gradual

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2
Q

name some causes of sudden visual loss (5)

A
  1. vascular - CRAO/CRVO
  2. vitreous haemorrhage
  3. retinal detachment
  4. ARMD - wet
  5. closed angle glaucoma
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3
Q

name the major blood supply to the eye

A

branches of the ophthalmic artery

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4
Q

in sudden visual loss, there can be _________ of retinal artery/vein or ___________ from abnormal blood vessels in DM or wet ARMD

A

in sudden visual loss, there can be OCCLUSION of retinal artery/vein or HAEMORRHAGE from abnormal blood vessels in DM or wet ARMD

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5
Q

is there pain in CRAO?

A

no

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6
Q

is there sudden visual loss in CRAO?

A

yes

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7
Q

what are the signs of CRAO?

A

RAPD

pale oedematous retina
thread-like retinal vessels

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8
Q

what is the other name for transient CRAO?

A

amaurosis fugax

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9
Q

what are the symptoms of transient CRAO/amaurosis fugax

A

transient painless visual loss

‘like a curtain coming down’

lasts 5mins with full recovery

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10
Q

what is seen on examination of transient CRAO?

A

nothing abnormal on examination

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11
Q

what’s the management in transient CRAO?

A

urgent referral to stroke clinic

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12
Q

what is central retinal vein occlusion associated with?

A

endothelial damage - diabetes

abnormal blood flow - HBP

hypercoaguable state - cancer

VIRCHOW’S TRIAD

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13
Q

what are the signs and symptoms of CRVO?

A

sudden visual loss

retinal haemorrhage
dilated tortuous veins
disc and macular swelling

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14
Q

pale macula and optic disc with small vessels

diagnosis?

A

CRAO

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15
Q

dark macula with swelling of disc and tortuous vessels

diagnosis?

A

CRVO

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16
Q

what arteries are involved in optic nerve circulation?

A

posterior ciliary arteries

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17
Q

occlusion of optic nerve head circulate is also known as what?

A

ischaemic optic neuropathy (ION)

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18
Q

what becomes occluded and what infarcts in ION?

A

posterior ciliary arteries are occluded and optic nerve head becomes infarcted

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19
Q

what inflammatory condition causes ischaemic optic neuropathy?

A

giant cell arteritis - GCA

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20
Q

what cells are present in GCA?

A

multinucleate giant cells

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21
Q

what is the other name for GCA?

A

temporal arteritis

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22
Q

what are the visual symptoms of ION?

A

sudden severe visual loss

irreversible blindness

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23
Q

what are the signs of ION?

A

pale, swollen optic nerve/disc

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24
Q

immediate treatment of ION may prevent what?

A

bilateral visual loss

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25
Q

what are the other symptoms of GCA?

A 
headache
jaw claudication
scalp tenderness
tender and enlarged arteries
malaise
amaurosis fugax
26
Q

where in the eye does haemorrhage often occur?

A

vitreous cavity - vitreous cavity

27
Q

in vitreous haemorrhage, bleeding occurs from what?

A

abnormal vessels such as in DM or CRVO

normal vessels in bridging a retinal tear

28
Q

what are the 2 symptoms of vitreous haemorrhage?

A

loss of vision

floaters

29
Q

what sign is seen in vitreous haemorrhage?

A

loss of red reflex

30
Q

is retinal detachment painful?

A

no

31
Q

what is the symptom of retinal detachment?

A

sudden flashes/floaters

32
Q

what are the signs of retinal detachment?

A

RAPD

tear on ophthalmoscopy

33
Q

name the 2 types of ARMD

A

wet and dry

34
Q

which ARMD causes sudden visual loss?

A

wet

35
Q

where do the new vessels in wet ARMD grow from?

A

choroid - through pigment epithelium and into the retina

36
Q

what are the symptoms of wet ARMD?

A

rapid central visual loss

37
Q

what is seen on ophthalmoscopy of wet ARMD?

A

haemorrhage

exudate

38
Q

which type of glaucoma causes sudden visual loss?

A

closed angle glaucoma

39
Q

what happens in closed angle glaucoma?

A

increased pressure gradient causes iris to bow forward and obstruct trabecular meshwork

40
Q

is closed angle glaucoma painful?

A

yes

41
Q

what are the signs and symptoms of closed angle glaucoma?

A 
painful
red eye
sudden
headache
nausea
vomitting

cloudy cornea
dilated pupil

42
Q

closed angle glaucoma treatment?

A

lower IOP with drops/oral medication to prevent blindness

43
Q

name the causes of gradual visual loss (5)

A 
cataract
dry ARMD
refractive error
glaucoma
diabetic neuropathy
44
Q

define cataract

A

cloudiness of the lens due to abnormal changes in lens proteins (crystallins)

45
Q

what are the causes of cataracts

A 
age
congenital
metabolic
steroids
UVB
46
Q

what is the other name for polychromatic cataract?

A

christmas tree cataract

47
Q

name the 3 main cataract types

A

nuclear cataract
posterior subcapsular cataract
congenital cataract

48
Q

what is the symptoms of cataract?

A

gradual decline in vision

glare - night when driving

49
Q

what is the management of cataract?

A

surgical removal with intra ocular lens implant if patient is symptomatic

50
Q

name the type of ARMD with gradual reduction in vision

A

dry ARMD

51
Q

what is the symptoms of dry ARMD?

A

gradual loss of central vision

52
Q

what is seen under the ophthalmoscope of someone with dry ARMD?

A

drusen

atrophic patches

53
Q

dry ARMD treatment?

A

no treatment

54
Q

what are the medical terms for the following refractive errors:

(a) short-sighted
(b) long-sighted
(c) irregular corneal curvature
(d) loss of accommodation with ageing

A

(a) myopia
(b) hypermetropia
(c) astigmatism
(d) presbyopia

55
Q

refractive error treatment?

A

glasses

eye cannot focus properly

56
Q

what are the symptoms of open angle glaucoma?

A

often none

optician may discover it

57
Q

what are the signs of open angle glaucoma?

A

cupped disc
visual field defect
may/may not have IOP

58
Q

what happens in open angle glaucoma?

A

drainage through the meshwork is poor

59
Q

in myopia, the focus of rays is ______ the retina

A

in myopia, the focus of rays is BEFORE the retina

60
Q

in hyperopia, the focus of rays is ______ the retina

A

in hyperopia, the focus of rays is BEHIND the retina

Ophthalmology (13 decks)

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