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My2 Ophthalmology > Visual loss > Flashcards

Visual loss Flashcards

1
Q

what ‘ABCD’ causes sudden visual loss

A

A: ARMD (wet), B: bleed/ blocked vessel (vitreous haemorrhage, occlusion), C: closed angle glaucoma, D: detached retina

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2
Q

what is the most common cause of blindness in the UK

A

age related macular degeneration

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3
Q

what is the pathophysiology of wet ARMD

A

abnormal new vessels grow under retina (choroid) mediated by VEGF, leakage causes fluid build up (oedema) which leads to scarring

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4
Q

what are symptoms (4) and signs (3) of wet ARMD

A

rapid central visual loss / blind spots (scotoma) / distortion (metamorphosia) / decreased brightness of colours / haemorrhage and hard exudates on retina (normal colour) / DRUSEN: yellow deposits of proteins and lipids / atrophic retina

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5
Q

how do you identify wet vs dry ARMD

A

OCT scan - drusen a key identification for ARMD

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6
Q

how do you treat wet ARMD

A

intravitreal injections and anti VEGF eg ranibizumab

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7
Q

what can causes a central retinal artery occlusion (CRAO)

A

carotid artery disease - (hypertension, stroke, atherosclerosis), emboli

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8
Q

what are symptoms (2) and signs (4) of a CRAO

A

sudden visual loss / painless / pale and oedema retina / thread like vessels, cherry red macula / (relative afferent pupil defect - pupils dilate in affected eye - must be V severe)

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9
Q

what is a brach retinal artery/ vein occlusion (BRA/VO)

A

branch off of central retinal artery/ vein - not as severe as not an end artery so not whole of retina is ischaemic

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10
Q

what is amaurosis fugax

A

transient painless visual loss / black curtain loss for a few minutes / usually from emboli

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11
Q

what is virchow’s triad

A

hypercoaguble state (eg cancer) /abnormal flow (eg hypertension) / endothelial damage (eg diabetes)

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12
Q

what are symptoms and signs of central retinal vein occlusion (CRVO) (5)

A

sudden visual loss / retinal haemorrhages / dilated torutous veins / disc swelling (hard to see cup and cone) and macular swelling /cotton wool spots (ischamia)

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13
Q

what is occlusion of optic nerve head

A

AKA ischaemic optic neuropathy (ION) - posterior ciliary arteries which are blood supply to CNII become occluded

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14
Q

what are symptoms and signs of ischaemic optic neuropathy (3)

A

sudden, painless visual loss, swollen optic disc

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15
Q

what is ION associated with

A

temporal arteritis (polymyalgia rheumatica, headache, claudication, tenderness)

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16
Q

what is a vitreous haemorrhage

A

bleeding from vessels into vitreous

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17
Q

what can cause vitreous haemorrhage

A

abnormal vessels from neovascularisation / new vessels eg retinal tear

18
Q

what are symptoms and signs of a vitreous haemorrhage (4)

A

loss of vision / floaters / loss of red reflex / haemorrhage on fundoscopy

19
Q

what is a closed angle glaucoma

A

increased pressure in eye from build up aqueous fluid/ blocked trabecular drainage network AND iris blocks access to drainage (closed angle)

20
Q

what are symptoms of closed angle glaucoma

A

(emergency), VV intense eye pain and headache / nausea and vomiting / sudden visual loss and halos / Females

21
Q

what are signs of closed angle glaucoma

A

acute red eye / cloudy cornea / dilated pupil (high pressure causes ischaemia and sphincter muscles cant contract)

22
Q

how do you treat closed angle glaucoma

A

zap hole in iris with laser, drugs: pilocarpine (miotic that constricts pupil), acetazolamide is a carbonic anhydrase inhib that reduces aqueous production)

23
Q

what can cause retinal detachment

A

with age vitreous becomes watery and can get in behind retina and pull it away

24
Q

what are symptoms of retinal detachment

A

painless, sudden visual loss / sudden FLASHES and FLOATERS of light in periphery / floaters

25
Q

what are signs id retinal detachment

A

‘crinkly’ retina / may have RAPD / may see tear / may have vitreous bleed

26
Q

what are the ABCDG of gradual vision loss

A

ARMD (dry) / Blur (refraction) / Cataracts / Diabetes/ Glaucoma

27
Q

what is the difference between wet and dry ARMD

A

no neovascularisation in dry type

28
Q

what are symptoms (1) and signs (2) of dry ARMD

A

gradual central visual loss / drusen on fundoscopy / atrophic retina

29
Q

how do you manage dry ARMD

A

no definitive treatment just visual aids

30
Q

what is blur or refractive error

A

light does not focus clearly on retina and eyes cannot focus and image - v common

31
Q

what is myopia

A

short sighted

32
Q

what is hypermetropia

A

long sighted

33
Q

what is astigmatism

A

irregularly shaped cornea

34
Q

what is presbyopia

A

loss of accommodation with age

35
Q

what are cataracts and what is the process that causes it

A

very common clouding/ opification of the lens by abnormal changes in lens proteins (crystallin)

36
Q

what are 4 types of cataracts

A

nuclear / posterior sub-capsular / Christmas tree cataract AKA polychromatic / congenital

37
Q

what can cause cataracts (5)

A

DIABETES, UV damage, hypertension, smoking, steroids

38
Q

how does diabetes cause cataracts

A

increases sugar in lens (sorbitol) which causes swelling and fibre disruption

39
Q

what are symptoms (4) and signs (1) of cataracts

A

gradual visual loss to hazy and blurry / opaque eye (unilateral) / changes in colour to brown or yellow / starbursts around light / LOSS OF RED REFLEX

40
Q

what is the main treatment of cataracts

A

surgical removal with intra-ocular lens implant

41
Q

what are symptoms of open angle glaucoma

A

often asymptomatic as so subtle and vision loss in periphery

42
Q

what should the cup to disc ration be and what is it in glaucoma

A

should be 0.6, in glaucoma >0.6

My2 Ophthalmology (12 decks)

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