Gradual Vision Loss

Question 1

what is the pathology of open angle glaucoma

Answer 1

imbalance of aqueous secretion and removal increases intra-ocular pressure causing retinal ischaemia and optic neuropathy

Question 2

what is the general presentation of open angle glaucoma

Answer 2

progressive decreased peripheral vision, usually bilateral

Question 3

what test is initially done when investigation open angle glaucoma

Answer 3

fundoscopy

Question 4

what is seen on fundoscopy in open angle glaucoma

Answer 4

disc cupping: increased cup:disc ratio, bayonetting

Question 5

what test is used to measure intra-ocular pressure

Answer 5

tonometry

Question 6

what medication is first line for open angle glaucoma

Answer 6

latanoprost

Question 7

what type of medication is latanoprost

Answer 7

prostaglandin analogue

Question 8

what medication might be added in conjunction with latanoprost after trialling only latanoprost

Answer 8

b-blocker timolol

Question 9

what type of medication of 2nd line to latanoprost

Answer 9

carbonic anhydrase inhibitors

Question 10

what is a side effect of carbonic anhydrase inhibitors

Answer 10

acidosis

Question 11

give 2 examples of carbonic anhydrase inhibitors

Answer 11

TOP dorzalamide

PO acetazolamide

Question 12

what type of age related macular degeneration causes gradual vision loss

Answer 12

dry type

Question 13

what is the pathology of age related macular degeneration dry type

Answer 13

Drusen build up under RPE causing atrophic retina patches

Question 14

what is the general presentation of age related macular degeneration dry type

Answer 14

bilateral gradual decreased central vision acuity and metamorphopsia

Question 15

what is seen on fundoscopy in age related macular degeneration dry type

Answer 15

haemorrhages and hard exudate

Question 16

what is the management of age related macular degeneration dry type

Answer 16

supportive e.g. vision aids

Question 17

what is the general pathology of diabetic retinopathy

Answer 17

proteins glycosylated, angiogenesis, pericyte loss, microaneurysms

Question 18

what is the general presentation of diabetic retinopathy

Answer 18

blurring, floaters, decreased colour vision, rubeosis iridis

Question 19

what is seen on fundoscopy in diabetic retinopathy

Answer 19

cotton wool spots, hard exudate, flame haemorrhages

Question 20

what is a complication of diabetic retinopathy

Answer 20

retinal detachment

Question 21

what is the management of diabetic retinopathy

Answer 21

PRP laser for new vessels or vitrectomy

Question 22

in what condition would you seen cotton wool spots, hard exudates, copper/silver wiring, retinal haemorrhages and papilledema on fundoscopy

Answer 22

hypertensive retinopathy

Question 23

what examination test helps identify congenital cataracts

Answer 23

red light reflex

Question 24

what is the pathology of cataracts

Answer 24

lens opacifications

Question 25

what is the general presentation of a cataract

Answer 25

hazy/blurred vision, night glares

Question 26

what is used to diagnose a cataract

Answer 26

slit lamp

Question 27

what is the main indicator for treatment in a cataract

Answer 27

symptoms

Question 28

what is the treatment of a cataract

Answer 28

phacoemulsification; removes and replaces lens

Question 29

what are the risk factors for cataracts

Answer 29

age, trauma, CCS, DM

Question 30

what is a differential for gradual visual loss

Answer 30

hypertensive retinopathy, diabetic retinopathy, ARMD dry type, open angle glaucoma, cataract, refractive error