Vision los

Question 1

Causes of sudden vision loss

Answer 1

Painful:
Acute glaucoma
Optic neuritis
GCA
Anterior uveitis 

painless and come and go:

Amaurosis fugax (lack of blood supply to eye)
Migraine
Raised ICP

Painless and constant:
Retinal detachment
Vitreous haemorrhage
Retinal vessel occlusion

Question 2

Gradual

Answer 2

Cataracts

Refractive errors

Question 3

Veil over eyes

Answer 3

Amaurosis fugax

Question 4

red painful eye with hazy sudden loss of vision with mild dilation

Answer 4

Acute glaucoma

Question 5

Other symptoms/signs in acute glaucoma

Answer 5

Cupped optic disc

Halo seen around lights

Question 6

Criteria for MS

Answer 6

Two or more CNS lesions with corresponding symptoms separated in time and space (lasts for longer than 24h and at least one month apart)

e.g. tingling and optic neuritis

Question 7

Symptoms of MS

Answer 7

Reduced visual acuity
Double vision
Nystagmus
Burning sensation in eye
Tremors
Weakness
Autonomic dysfunction (e.g. bladder or bowel problems)

Question 8

What is Temporal arteritis?

Answer 8

Inflammation of temporal arteries, formation of granulomas causing ischemia

Question 9

Symptoms + associated symptoms/distribution of pain in GCA

Answer 9

Unilateral headache in the distribution of the temporal artery
Pain upon eating (jaw claudication)
Pain when brushing hair

Double vision
Blurred vision
Vision Loss

Question 10

Which condition is GCA associated with?

Answer 10

Associated with polymyagia rheumatica

Question 11

Main cause of anterior uveitits

Answer 11

Autoimmune conditions

Question 12

Symptoms and signs of anterior uveitis

Answer 12

Painful and increased lacrimation and photophobia
Blurring
Red watery eyes

Question 13

Main cause of posterior uveitits

Answer 13

Infective

Question 14

Symptoms of posterior uveitis

Answer 14

Painless
Floaters
Scotomata (vision changes e.g. in auras)

Question 15

What is a migraine aura?

Answer 15

Speech disturbances, blurry vision

Question 16

Who does migraine affect more?

Answer 16

Women

Question 17

What is cataract + causes of cataracts

Answer 17

Opacification of the lens

Age related
DM retinopathy
Chronic glaucoma
Also steroids

Question 18

What would someone with cataract see?

Answer 18

Glare from bright light
Halo around light
Washed out colour vision (e.g. less richness in the colours, esp blues)

Question 19

Features of cataracts in someone with chronic glaucoma

Answer 19

Bilateral vision loss from periphery to inner side

Question 20

Is it painful in cataracts?

Answer 20

No, gradual-onset painless loss of vision

Question 21

What questions would you ask about the vision loss?

Answer 21

Unilateral or bilateral?
Sudden or gradual onset?
Clarify the vision loss (diplopia etc)
Worse when coughing? (Raised ICP)
How long does it last?
When does it come on?
Does anything make it better or worse?

Question 22

What PMH might you ask about?

Answer 22

Previous Hx of eye problems ​
Glaucoma ​
MS​
Trauma to head/ face ​(retinal detachment)
Previous Hx of migraines​
Atherosclerotic risk factors: hypertension, diabetes, dyslipidemia​
Autoimmune conditions ​
Infections: ​
varicella zoster virus

Question 23

What might you ask about in FH?

Answer 23

Glaucoma/ Eye problems ​
CVS risk factors ​
Stroke/ TIAs​
MS