5: Visual loss and blindness Flashcards Preview

Ophthalmology Week 2 2017/18 > 5: Visual loss and blindness > Flashcards

Flashcards in 5: Visual loss and blindness Deck (65)
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1

What is the major artery supplying the eye?

Which artery in the neck does it stem from?

Ophthalmic artery

Internal carotid artery

2

What are the important branches of the ophthalmic artery which you should know?

Central retinal artery (inner 2/3rds of retina)

Posterior ciliary arteries (optic nerve head)

3

Which structure supplies the other 1/3rd of the retina?

Choroid

4

What vascular problems cause sudden visual loss?

Occlusion

Haemorrhage

5

Which artery supplies the inner 2/3rds of the retina?

Central retinal artery

6

What are the symptoms of central retinal artery occlusion?

Sudden profound vision loss

Which is painless

7

What reflex is disrupted in CRAO?

Pupillary light reflex

pupil doesn't constrict in response to light - relative afferent pupil defect (go back and forth fast enough and the pupil will actually dilate in response to light)

because optic nerve is infarcted

8

What does the retina look like in a central retinal artery occlusion?

Pale

Cherry spot fovea

Arteries either absent or blocked

9

Central retinal artery occusion is a type of ___.

stroke

10

What causes central retinal artery occlusion?

Carotid artery disease

11

How are central retinal artery occlusions managed?

Ocular massage (attempt to convert to branch occlusion)

Manage risk factors

12

What is amaurosis fugax?

Transient central artery occlusion

13

What are the symptoms of amaurosis fugax?

Transient painless visual loss

lasting 5 mins with full recovery

14

How is amaurosis fugax treated?

Aspirin (anti-platelet)

Urgent referral to stroke clinic

15

What is Virchow's triad?

Endothelial injury

Hypercoagulability

Stasis / turbulent blood flow

16

What are the symptoms of central retinal vein occlusion?

Sudden painless visual loss

17

CRVO is associated with a raised ___ pressure.

intraocular

18

What are the signs of CRVO on fundoscopy?

Haemorrhages - inc. cotton wool spots

Dilated torturous veins

Optic disc and macular swelling

19

What type of scan is used to pick up macular oedema?

OCT scan

20

How is CRVO treated?

Laser treatment

Anti-VEGF injections (VEGF released in response to ischaemia, encourages development of poorly structured blood vessels which haemorrhage)

Address risk factors

21

What processes drive

a) arterial

b) venous

occlusions of the eye?

a) Internal carotid disease

b) Venous stasis

22

Which arteries supply the optic nerve head?

Posterior ciliary arteries

23

What is occlusion of the posterior ciliary arteries also known as?

Ischaemic optic neuropathy

24

What tends to cause arterial ischaemic optic neuropathy?

Giant cell arteritis

25

What causes non-arteritic ischaemic optic neuropathy?

Atherosclerosis

26

What does the optic disc look like in ischaemic optic neuropathy?

Swollen

27

What is the main symptom of arteritic ischaemic optic neuropathy?

Sudden irreversible visual loss

28

Irreversible blindness is an end-stage symptom of giant cell arteritis. What are the other symptoms?

Headache

Jaw claudication

Scalp tenderness

Tender, enlarged temporal arteries

Transient arterial occlusions (amaurosis fugax)

Malaise

Raised inflammatory markers

29

How is giant cell arteritis treated to prevent immediate bilateral blindness?

High dose oral prednisolone

30

Where in the eye does bleeding tend to occur?

Vitreous cavity