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Ophthalmology > Visual Loss and Blindness > Flashcards

Visual Loss and Blindness Flashcards

1
Q

What are some causes of sudden vision loss?

A

Retinal vein/artery occlusion, vitreous haemorrhage, retinal detachment, closed angle glaucoma, optic neuritis, stroke, wet type age related macular degeneration

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2
Q

What are the symptoms of central artery occlusion?

A

Painless sudden visual loss, relative afferent pupil defect, pale oedematous retina, thread-like retinal vessels

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3
Q

What are some causes of retinal artery occlusion?

A

Carotid artery disease, emboli form heart (rare)

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4
Q

Can branches of the retinal artery/vein become occluded?

A

Yes = also cause sudden visual loss

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5
Q

What is amaurosis fugax?

A

Transient central artery occlusion = urgent referral to stroke clinic

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6
Q

What are the symptoms of amaurosis fugax?

A

Transient painless visual loss = lasts 5 mins with full recovery, “like curtain coming down”
No abnormal signs on examination

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7
Q

What are some associations of central vein occlusion?

A

Endothelial damage (diabetes), abnormal blood flow (hypertension), hypercoagulable state (cancer)

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8
Q

What are the symptoms of central vein occlusion?

A

Sudden visual loss (variable), retinal haemorrhage, dilated tortuous vein, disc and macular swelling

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9
Q

What causes ischaemic optic neuropathy?

A

Occlusion of the optic nerve head circulation = posterior ciliary arteries become occluded causing ischaemia

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10
Q

What is an association of ischaemic optic neuropathy?

A

Giant cell arteritis = medium/large sized arteries are inflamed, lumen of artery becomes occluded due to gross thickening of artery wall

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11
Q

What is needed to prevent blindness due to ischaemic optic neuropathy?

A

Prompt diagnosis and immediate treatment

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12
Q

What are the symptoms of ischaemic optic neuropathy?

A

Sudden severe visual loss, irreversible blindness, swollen optic nerve

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13
Q

What are some symptoms of giant cell arteritis?

A

Temporal headache, jaw claudication, scalp tenderness, tender/enlarged scalp arteries, amaurosis fugax, malaise

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14
Q

What are some causes of abnormal vessels?

A

Retinal ischaemia in diabetes, retinal vein occlusion causes abnormal fragile new blood vessels to form

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15
Q

What is a vitreous haemorrhage?

A

Haemorrhage of blood into areas in and around the vitreous humour = located between lens and retina

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16
Q

What are the symptoms of vitreous haemorrhage?

A

Sudden loss of vision, haemorrhage, loss of red reflex,

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17
Q

What are the symptoms of retinal detachment?

A

Painless sudden loss of vision, sudden onset of flashes/floaters, relative afferent pupil defect, tear seen on ophthalmoscopy

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18
Q

Why is there sudden onset of flashes/floaters in retinal detachment?

A

Due to mechanical separation of sensory retina from the retinal pigment epithelium

19
Q

What is the most common cause of blindness in the west in patients > 65?

A

Age related macular degeneration

20
Q

What are some risk factors for age related macular degeneration?

A

Increasing age, smoking, positive family history, poor nutrition

21
Q

What are the two kinds of age related macular degeneration?

A

Wet and dry

22
Q

What occurs in wet type macular degeneration?

A

New blood vessels grow under retina = leakage causes build up of blood and eventual scarring

23
Q

What are the symptoms of wet type macular degeneration?

A

Rapid sudden central visual loss, distortion, haemorrhage/exudate

24
Q

What is glaucoma?

A

Progressive optic neuropathy = results in optic nerve damage and visual loss

25
Q

What occurs in closed angle glaucoma?

A

Aqueous humour encounters increased resistance through iris/lens channel

26
Q

What does the increased pressure gradient in closed angle glaucoma cause?

A

Causes peripheral iris to blow out = obstructs trabecular meshwork

27
Q

How is blindness prevented in closed angle glaucoma?

A

Need to lower intra-ocular pressure with drops/oral medication = acute onset is ophthalmic emergency

28
Q

What are the symptoms of closed angle glaucoma?

A

Painful red eye, sudden visual loss, headache, nausea, vomiting, cloudy cornea, dilated pupil

29
Q

What are some features of gradual visual loss?

A

Usually bilateral, often asymmetrical, may present early with reduced visual acuity or late with decreased field

30
Q

What are the causes of gradual visual loss?

A

Cataract, dry type age related macular degeneration, open angle glaucoma, diabetic retinopathy

31
Q

What are cataracts?

A

Cloudiness of the lens

32
Q

What causes cataracts?

A

Abnormal changes in lens proteins (crystallins) result in their chemical/structural alteration = leads to loss of transparency

33
Q

What is the number one cause of preventable blindness worldwide?

A

Cataracts

34
Q

What are some associations of cataracts?

A

Age, congenital, trauma, diabetes, steroids

35
Q

What are the different types of cataracts?

A

Nuclear, subcapsular, Christmas tree (polychromatic)

36
Q

What are some symptoms of cataracts?

A

Gradual decline in vision (hazy/blurred) that can’t be corrected with glasses, may get glare (disabling at night when driving)

37
Q

What is the management for cataracts?

A

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

38
Q

What are the symptoms of dry type age related macular degeneration?

A

Gradual decline in vision, central vision missing (scotoma), build up of waste products below RPE (Drusen sign), atrophic patches of retina

39
Q

What is the treatment for dry type age related macular degeneration?

A

Supportive = low vision aids (e.g magnifiers)

40
Q

What is the main complaint in refractive errors?

A

Eye can’t focus on image = need glasses to correct

41
Q

What are the types of refractive errors in the eye?

A 
Myopia = short sighted     
Hypermetropia = long sighted
Astigmatism = usually irregular corneal curvature 
Presbyopia = loss of accommodation with ageing
42
Q

What is strange about open angle glaucomas?

A

They often have no symptoms

43
Q

What are some signs of an open angle glaucoma?

A

Cupped disc, visual field defect, may have high intra-ocular pressure

Ophthalmology (20 decks)

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