Eye & Vision Flashcards
(30 cards)
What does CVI stand for?
Certificate of Vision Impairment
Who might be eligible for a CVI?
Any patient with a serious eye disorder
What are the criteria for severe sight impairment?
- Visual acuity worse than 3/60 Snellen
- Visual acuity between 3/60 and 6/60 Snellen with contraction of visual fields
- Visual acuity above 6/60 Snellen with contraction of visual fields which is functionally impairing the patient
What are the criteria for sight impairment (not severe)?
- 3/60 to 6/60 Snellen with full visual fields
- 6/60 to 6/24 Snellen with moderately impaired visual fields
- 6/18 or better with marked visual field defect
What are the benefits to patient of registering for a CVI?
Eligibility for assistance/benefits (financial and welfare)
Eligibility for vision rehabilitation
Travel benefits/Blue badges
TV licence discount
Audiodescriptive services
Assistance and concessions from companies
Rights under Equality Act
How does a patient receive a CVI?
Needs to be initiated by ocular clinic (hospital/consultant) then registered in the community
What is a superficial corneal injury?
Non-penetrating injury affecting the outermost layer of the cornea
Why is the cornea the most susceptible part of the eye for injury?
It is the most anterior part of the eye
Why are corneal injuries so painful?
The cornea is densely innervated by sensory fibres from trigeminal nerve
What are the common causes of superficial corneal injuries?
-Mechanical trauma
-Foreign bodies
-Burns
-Contact lenses
-Recurrent erosions
What 4 serious complications can arise from superficial corneal injury?
-Corneal ulceration
-Infective keratitis
-Iritis
-Recurrent erosion syndrome
How quickly will most superficial corneal injuries take to heal?
2-5 days depending on how widespread injury is
A patient wearing glasses attends surgery with gritty feeling in his eye, pain on blinking and conjunctival redness.
What other features may be present in this presentation?
Superficial corneal injury
Hx of contact lens use
Lacrimation
Photophobia
Blurred vision
Blepharospasm
What are the red flags we should ask about in a case of superficial corneal abreasion?
-Significant vision changes
-Significant trauma
-Marked eye pain, headache, or photophobia
Can UV light exposure cause superficial corneal injury?
Yes
A metal-worker attends their GP with a hx foreign body in the eye and ongoing visual disturbance.
What signs would be concerning for globe rupture? What would this represent?
Blue/brown/black material on surface of eye - this is iris or choroid plugging the wound
A metal-worker attends their GP with a hx foreign body in the eye and ongoing visual disturbance.
What signs would indicate a penetrating trauma affecting the pupil?
Dilated, non-reactive, or irregular pupil, or protruding iris
If corneal abrasion due to contact lenses occurs, should primary care commence antibiotics?
No - this could affect microbiological specimens taken in secondary care
What generic information should be given to patients with superficial corneal injuries?
-Wearing sunglasses or staying out of bright light can help with photophobia
-Wear eye protection/avoid injury mechanism
-Don’t rub/touch eye or wear contacts while eye is recovering
A patient presents to GP with new onset ongoing visual floaters and progressive visual loss.
What is the most concerning differential?
Retinal detachment
A patient presents to GP with new onset ongoing visual floaters and progressive visual loss.
What other symptoms may make you more concerned about retinal detachment?
New onset flashing
Painless visual loss
Reduced visual acuity/blurring of vision, progressively worsening
A patient presents to GP with new onset ongoing visual floaters and progressive visual loss.
What risk factors may be present in the history for retinal detachment?
History of eye trauma
Recent eye surgery
Diabetic retinopathy
A patient presents to GP with new onset ongoing visual floaters and progressive visual loss.
What should the management plan be?
Possible retinal detachment
Immediate referral to ophthalmologist if there are signs of sight-threatening disease
Who should initiate corticosteroid eye preparations?
Specialist in secondary care
