5 - Opth - Acute loss of vision - Optic disc swelling, Optic atrophy, Vitreous haemorrhage, Macular haemorrhage, Causes of bilateral acute painless vision loss

Question 1

OD swelling - appearance

Answer 1

disc contour appears blurred/poorly defined and pink

Question 2

3 causes of OD swelling

Answer 2

Optic neuritis
Papilloedema
Anterior ischaemic optic neuropathy

Question 3

Optic neuritis - features - what is no disc swelling?

Answer 3

blurring vision
RAPD
red desaturation
retrobulbar aching
eye movements painful

no swelling + retrobulbar neuritis

Question 4

optic neuritis - common associations

Answer 4

commonly related to MS, also infections TB Syphilis

Question 5

Papilloedema - 5 features

Answer 5

bilateral disc swelling due to inc IOP,
headache,
transient blurring + enlarged blind spots,
Severe > splinter haemorrhages, exudates, cotton wool spots,
Eventual atrophy

Question 6

Optic Atrophy -appearance? when occurs? causes what?

Answer 6

disc pallor from lost axons, glial proliferation and decreased vascularity

without OD swelling OR following OD/ swelling

causes APD

Question 7

2 main causes of Optic Atrophy

Answer 7

Optic nerve disease

Primary retinal disease (retinal vv/aa occulsion)

Question 8

Other causes of optic atrophy

Answer 8

retinitis pigmentosa, toxic retinopathy, syphilis

Question 9

Different optic nerve diseases that may cause atrophy

Answer 9

optic neuritis, papilloedema, ischaemic optic neuropathy, primary open angle glaucoma, optic nerve compression

Question 10

Vitreous haemorrhage - causes

Answer 10

neovascularisation
retinal tear
PVD
trauma

Question 11

Vitreous haemorrhage - presentation

Answer 11

floaters, blurred vision, red tint to vision, dark streaks in vision, field defects, often worse in morning

Question 12

Macular haemorrhage - causes

Answer 12

proliferative diabetic retinopathy
AMD
macroaneurysms

Question 13

macular haemorrhage - presentation

Answer 13

scotoma, distortion

Question 14

Three areas that can cause bilateral acute painless vision loss

Answer 14

chiasm, optic nerve, cortex

Question 15

Chiasm causes of bilateral acute painless vision loss

Answer 15

pituitary tumours, pituitary apoplexy

Question 16

Optic nerve causes of bilateral acute painless vision loss

Answer 16

optic neuritis, severe papilloedema,

infiltration

Question 17

Cotical causes of bilateral acute painless vision loss

Answer 17

TIA, CVA, Migraine