Acute Vision Loss

Question 1

what type of glaucoma causes acute vision loss

Answer 1

acute closed angle glaucoma

Question 2

what is the pathology of acute closed angle gluacoma

Answer 2

increased intra-ocular pressure, resistance to aqueous flow at iridocorneal angle

Question 3

is farsighted or shortsighted a risk factor for acute closed angle glaucoma

Answer 3

farsighted

Question 4

is acute closed angle glaucoma more commonly unilateral or bilateral

Answer 4

unilateral

Question 5

what are the main symptoms of acute closed angle glaucoma

Answer 5

pain, vomiting, headache, acute vision loss

Question 6

what is seen on examination in acute closed angle glaucoma

Answer 6

injected scleral vessels
mid dilated pupil
cloudy cornea

Question 7

what is the management of acute closed angle glaucoma

Answer 7

diamox then lazer procedure

Question 8

what is the presentation of a retinal detachment

Answer 8

painless vision loss, floaters, curtain coming down

Question 9

is shortsightedness or farsightedness a risk factor for retinal detachments

Answer 9

short sighted

Question 10

what type of age related macular degeneration causes acute vision loss

Answer 10

wet type

Question 11

what is the pathology of age related macular degeneration wet type

Answer 11

angiogenesis under retina leak blood

Question 12

what is the presentation of age related macular degeneration wet type

Answer 12

decreased central vision acuity, metamorphopsia

Question 13

what is the management of age related macular degeneration wet type

Answer 13

intravitreal anti-VEGF

Question 14

what is the presentation of central retinal artery occlusion

Answer 14

profound painless monocular loss

Question 15

what is seen on fundoscopy in central retinal artery occlusion

Answer 15

pale, cherry red spot, edematous retina, thread-like retinal vessels

Question 16

what scan is used to determine the cause of central retinal artery occlusion

Answer 16

Carotid doppler

Question 17

what is the management of central retinal artery occlusion with less than 24 hours since onset

Answer 17

ocular massage

Question 18

what is the presentation of central retinal vein occlusion

Answer 18

painless moderate-severe monocular loss

Question 19

what is seen on fundoscopy in central retinal vein occlusion

Answer 19

retinal haemorrhages, dilated tortuous veins, disc swelling, macular swelling, dark

Question 20

what scan is used to diagnose a central retinal vein occlusion

Answer 20

OCT scan (??? true)

Question 21

what is the management of a central retinal vein occlusion

Answer 21

intravitreal anti-VEGF

Question 22

what is the pathology of ischaemic optic neuropathy

Answer 22

posterior ciliary artery occlusion causing optic nerve head infract

Question 23

what is a cause of ischaemic optic neuropathy

Answer 23

giant cell arteritis of ophthalmic artery

Question 24

what is seen on fundoscopy in ischaemic optic neuropathy

Answer 24

pale swollen disc

Question 25

what is the presentation of ischaemic optic neuropathy

Answer 25

irreversible profound vision loss

Question 26

what is amaurosis fugax

Answer 26

transient ophthalmic artery occlusion

Question 27

what is the presentation of amaurosis fugax

Answer 27

curtain coming down less than 5 minutes

Question 28

what is the management of amaurosis fugax

Answer 28

aspirin

Question 29

what vessels are affected by giant cell arteritis

Answer 29

medium size ophthalmic / temporal artery

Question 30

what age is most at risk of giant cell arteritis

Answer 30

elderly

Question 31

what is the main presentation of giant cell arteritis

Answer 31

temporal tender headache, jaw claudication, weight loss, enlarged scalp arteries, amaurosis fugax

Question 32

what condition do 50% of giant cell arteritis patients also have

Answer 32

polymyalgia rheumatica

Question 33

what abnormalities are seen on blood tests in giant cell arteritis

Answer 33

increased ESR, CRP & PV

Question 34

what test is diagnostic of giant cell arteritis

Answer 34

artery biopsy

Question 35

what is the problems with biopsies in giant cell arteritis

Answer 35

lots of false negatives due to skip lesions

Question 36

what is the management of giant cell arteritis

Answer 36

high dose oral steroids + PPI + aspirin

Question 37

why do you give aspirin for giant cell arteritis

Answer 37

to decrease the risk of ischaemic optic nueropathy

Question 38

what is a differential for acute vision loss

Answer 38

central retinal artery/vein occlusion, amaurosis fugax, ischaemic optic neurpathy, vitreous haemorrhage, retinal detachment, stroke, optic neuritis, wet ARMD, ACAG

Question 39

what may be seen on examination in central retinal vein occlusion

Answer 39

rubeosis iridis