Abnormal VS Normal Flashcards
(25 cards)
Primary open-angle glaucoma management
Routine referral
Primary open-angle glaucoma signs
Loss of ISNT rule
Disc asymmetry >0.2
Vertical enlargement of cup
large disc>0.7
Focal narrowing or notching of NRR
Visible lamina cribosa pores
Pallor
Saucerisation
Baring of circumlinear vessels
Bayonetting
Collaterals
Disc haemorrhages
Peripapillary atrophy
RNFL thinning
Flame shaped haemorrhage at disc rim
Primary open-angle glaucoma risk factors
Ocular hypertension
older age
family history in first degree realtive
people of west african descent including african-caribbean (onset at younger age)
thinning corneal thickness
high myopia>4D
diabetes
systemic hypertension and other vascular risk factors
Primary open-angle glaucoma DDX
ocular hypertension
tilted optic disc
physiological cupping
disc drusens
anterior ischaermic optic neuropathy (AION)
secondary glaucoma
optic atrophy
any condition with glaucoma like VF defect
Ocular hypertension signs
IOP>21
normal VF
no ONH damage
no other pathology to expalin high IOP
open drainage angle of gonioscopy with normal appearance
asymptomatic
Ocular hypertension Risk factors
High blood pressure
Race (Afro-Caribbean)
Ageing
Ocular hypertension DDX
POAG
PACG
Secondary ACG
Normal tension glaucoma signs/symptoms
IOP>21
VF defect (paracentral scotoma)
Abnormal ONH (glaucomatous optic neuropathy)
peripheral vasospasm
symptoms: migraine/asymptomatic
Normal tension glaucoma DDX
POAG
intermittent ACG
secondary OAG
Ischaemic optic neuropathy
Normal tension glaucoma risk factors
hypotension
thinner corneas
glaucomatous optic neuropathy
gender (female x2 risk than men)
Acute angle closure glaucoma DDX
Red eye: acute conjunctivitis, uveitis, keratitis, trauma
High IOP: inflammation, neovascular glaucoma, secondary angle closure glaucoma
Acute angle closure glaucoma risk factors
positive family history of ACG
hyperopia/short axial length
ethnicity (Chinese)
age (over 40)
Optic neuritis signs
rapid loss of vision in one eye
retro-orbital ocular pain
visual loss is made worse by heat or exercise
optic neuritis symptoms
RAPD
VA loss mild to severe
central scotoma
severely impaired colour vision
normal fundus/blurred disc margins
swollen veins
Optic neuritis management
urgent referral
optic neuritis risk factors
young age
women 3x more than men
multiple sclerosis
viral infection
tuberculosis
syphilis (STI)
Optic neuritis DDX
arteritic anterior ischaemic optic neuropathy
non arteritic anterior ischaemic optic neuropathy
papilloedema
Papilloedema signs (mechanical)
elevation of ONH
blurring of optic disc margins
filling of the physiological cup
oedema of peripapillary RNFL
retinal or choroidal folds
Papilloedema signs (vascular)
hyperaemia of the disc
loss of spontaneous venous pulsation and venous congestion
papillary/peripapillary haemorrhages
hard exudates
cotton wool spots
enlarged blind spot
diplopia (6th CN palsy)
Papilloedema management
urgent referral
papilloedema symptoms
severe headache
nausea
explosive vomitting
normal vision/sudden blanking of vision lasting seconds
brain tumours
meningitis
hydrocephalus
pseudo-tumour cerebri
papilloedema DDX
Optic disc drusens
malignant hypertensive
anterior ischaemic optic neuropathy
optic neuritis
central retinal vein occlusion
pseudopapilloedema
hypertensive retinopathy signs
focal arteriolar narrowing
arteriosclerotic changes
nerve fibre haemorrhages (flame-shaped)
cotton wool spots
disc oedema
macular star of exudates
hypertensive retinopathy DDX
diabetic retinopathy
central retinal vein occlusion
radiation retinopathy
