Loss of Vision UNFINISHED Flashcards
Important history taking questions when consulting a patient with loss of vision?
- Unilateral or bilateral?
- Onset: sudden or gradual?
- Type of visual loss? (blurred / distorted / blackness)
- Associated symptoms? (pain / discharge etc.)
What is the macula?
Oval shaped pigmented (dark) area on the retina (contains the fovea)
What is Amsler chart testing?
A test for macular degeneration / optic nerve problems
- Put a grid in front of the patient, ask them to stare at the dot in the middle with each eye and say if any of the lines appear distorted
What is colour vision testing?
Those mad chart things with coloured numbers on different colour background, see if the patient can distinguish the number / word from the background
What is fluorescein angiography?
Fluorescein dye injected into the bloodstream, travels to the eye and highlights the vessels of the eye - then take pictures of the eye to look at vascular structure
What is Optical Coherence Tomography?
Uses different wavelengths of light to take cross sectional pictures of the retina, allowing visualization of the layers
Some bloke comes in with loss of vision, list the possible investigations you might go for
- Snellen chart testing
- Amsler chart testing
- Fundoscopy
- Colour vision test
- Visual field examination
- fluorescein angiography
- Optical coherence tomography
What are some causes of sudden complete loss of vision?
- Central retinal artery occlusion
- Central retinal vein occlusion
- Anterior ischaemic optic neuropathy
Management of central retinal artery occlusion?
- “Identify and treat risk factors” - slides
Web: choices include fluid release, hyperbaric oxygen therapy and anti-clotting drugs
Management of central retinal vein occlusion?
- Intravitreal anti-Vegf
anti-vascular endothelial growth factor
What are the two types of anterior ischaemic neuropathy? How to differentiate between the two?
- Arteritic: giant cell arteritis
- Non-arteritic
- Non-arteritic is painless
Symptoms of giant cell arteritis anterior ischaemic neuropathy?
- Loss of vision
- Headache
- Loss of appetite
- Scalp tenderness
- Pain on chewing
Signs of giant cell arteritis anterior ischaemic neuropathy?
- Tenderness of superficial temporal arteries
- Raised inflammatory markers
Management of giant cell arteritis anterior ischaemic neuropathy?
High dose systemic steroids
stop inflammation
Management of non-arteritic anterior ischaemic neuropathy?
Identify and treat risk factors
