Evaluation of vision loss Flashcards
(22 cards)
Loss of vision?
Loss of central vision or loss of part of the visual field
When does loss of vision occur?
When there is pathology along the visual pathway
A scotoma (blind spot) is one eye is associated with?
A retinal or optic nerve lesion in that eye
Where do optic nerve disease typically cause scotomas?
Centrally
Chiasmal compression causes?
Bitemporal visual field defect
Damage to the visual pathways behind the chiasm produce?
homonymous hemianopsi (defect affects the same side of the patient’s visual field in both eyes)
If a patient has a congruous homonymous hemianopsia, where is the lesion?
Occipital Cortex, more congruous the closer to the Occipital cortex
Characteristics of optic neuritis?
Occurs in young or middle age adults Sudden loss of vision in one eye May have pain on motion of eye Afferent pupillary defect present Central visual field defect Color desaturation in affected eye (mostly red) Disc normal or swollen
What does the optic disc look like in retrobulbar optic neuritis?
Normal
What does the optic disc look like in papillitis?
Swollen
How does vision loss proceed in optic neuritis?
over 10-14 days
Improvement of vision in optic neuritis occurs over what time period?
3 or more weeks
Optic neuritis is associated with what?
Multiple sclerosis
Most common cause of compression of optic chiasm?
Pituitary adenoma
What is papilledema?
Bilateral swelling of the optic discs secondary to increased intracranial pressure
What does papilledema indicate?
SERIOUS Neurological problem
Most common causes of papilledema?
Brain tumor
Pseudotumor cerebri
Characteristics of papilledema?
Visual acuity normal Visual field full with enlarged blind spot No pain on eye movement No afferent pupillary defect HA, nausea, and vomiting common \+/- CN VI nerve palsy
Signs of papilledema?
Both discs elevated and hyperemic Disc margins blurred, indistinct Small vessels at margin obscured Retinal vessels tortuous, dilated Hemorrhages and exudates Spontaneous venous pulsations ABSENT
Characteristics of ischemic optic neuropathy?
Acute loss of vision in older patient Usually only one eye Afferent pupil defect present Disc is swollen and PALE Ischemia of disc (small artery occlusion) Altitudinal hemianopsia common Must R/O temporal arteritis
Characteristics of optic atrophy?
Suggested by pale color of disc
Usually poor vision and visual field defect
May be caused by lesion in retina, optic nerve, chiasm, or optic tract
Multiple causes
Characteristics of chronic open angle glaucoma?
Ocular disease usually associated with increased intraocular pressure
Optic nerve is damaged
Enlargement of optic cup and eventual pallor (atrophy)
Early visual field loss (asymptomatic)
Loss of central vision (LATE)
