Sudden Painless Loss of Vision

Question 1

What are 5 causes of sudden painful vision loss?

h: Optical Issues Really Obscure Vision

Answer 1

Occlusion of retinal vein
Ischaemic optic neuropathy
Retinal detachment
Occlusion of retinal artery
Vitreous haemorrhage

Question 2

Causes of retinal vein occlusion? (3)

Answer 2

Hypertension,
Glaucoma,
Polycythaemia

Question 3

Presentation of retinal vein occlusion? (2)

Answer 3

Sudden painful monocular vision loss OR

Dense central scotoma

Question 4

Diagnostic test for retinal vein occlusion? and what would you see with this test?

Answer 4

Fundoscopy

• Retinal haemorrhage
• Retinal oedema

Question 5

Investigations used for retinal vein occlusion? (6)

Answer 5

Visual acuity,
Pupil analysis, 
Intraocular pressure,
Anterior slit lamp examination,
Fundoscopy,
Fluoroscein angiography

Question 6

What is seen on a fluoroscein angiography in retinal vein occlusion? (3)

Answer 6

• retinal capillary ischaemia
• macular oedema
• neovascularisation

Question 7

Treatment for retinal vein occlusion?

Answer 7

Manage RF,
For macular oedema- intravitreal anti-VEGF or steroids
For neovascularisation- laser photocoagulation
Surgical- vitrectomy

Question 8

What is ischaemic optic neuropathy?

Answer 8

Damage to optic nerve caused by a blockage of its blood supply.

Question 9

Causes of ischaemic optic neuropathy? (2)

Answer 9

Temporal arteritis,

Atherosclerosis

Question 10

RF for ischaemic optic neuropathy (7)

Answer 10

Age, 
Male, 
\+ve FH, 
DM, 
hypertension, 
smoking, 
obesity

Question 11

Presentation of ischaemic optic neuropathy?

Answer 11

Visual loss- normally on waking

May be associated with temporal arteritis s/s

Question 12

Investigations for ischaemic optic neuropathy? (4)

Answer 12

ESR,
CRP,
FBC,
Temporal a. biopsy

Question 13

Treatment for ischaemic optic neuropathy?

Answer 13

Prednisolone (for temporal arteritis)