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Clin Med Exam 2 (Lauren) > Vision Loss > Flashcards

Vision Loss Flashcards

(42 cards)

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1
Q

How should you test visual fields?

A

One eye at a time

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2
Q

Which kind of glaucoma is more rare?

A

Acute angle closure glaucoma

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3
Q

What is the mechanism of acute angle closure glaucoma?

A

Acute rise of IOP due to outflow obstruction

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4
Q

What type of glaucoma:
Chronic narrowing of angle

Optic neuropathy

IOP not elevated significantly

Optic nerve damage

A

Open angle glaucoma

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5
Q

Can both types of glaucoma cause optic nerve damage?

A

Yes

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6
Q

Name the glaucoma:

Acute decreased vision

Halos around lights**

Headache

Nausea and vomiting

Severe eye pain

Feeling of pressure

STEAMY cornea***

Dilated pupil

Narrow anterior chamber

Firm globe

A

Acute angle glaucoma

STEAMY
HALOS

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7
Q

What do you need to do right away if you see acute angle closure glaucoma? (Before they even go to ophthalmology)

A

Start on topical ocular hypertension meds:
Beta-blockers

Alpha-2 agonists

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8
Q

What should you NOT do to someone with acute angle closure glaucoma?

A

Give Mydriatics (DO NOT DILATE THEIR PUPILS)

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9
Q

Name the glaucoma:

Asymptomatic early

CHronic painless vision loss that starts peripherally

Increased cup/disc ratio

No AV nicking

No exudates

A

Open angle glaucoma

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10
Q

What kind of glaucoma is an emergency

A

Acute angle closure

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11
Q

How do you manage open angle glaucoma?

A

Refer to ophtho, but it is not an emergency

Topical ocular hypertension meds

Laser trabeculoplasty/surgical trabeculectomy

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12
Q

What can cause cataracts?

A

Age related

Congenital

Traumatic

Long term steroid therapy

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13
Q

Name it:
Lens opacity

Gradual, chronic, painless loss of vision

“Foggy vision”

Decreased visual acuity

Clouding/opalescent changes to lens

A

Cataract

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14
Q

How do you manage cataracts

A

Refer to ophthalmology if their lifestyle is affected.

Surgery has an excellent prognosis

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15
Q

What is the #1 cause of central legal blindness in Western world?

A

Macular degeneration

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16
Q

Name it:
Gradual or acute blurred vision

Metamorphosis (wavy vision)

Central scotoma (blind spot)

Amsler grid distortion

+/- decreased vision

A

Macular degeneration

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17
Q

Which is worse: wet or dry age related macular degeneration?

18
Q

Wet or Dry ARMD:

Drusen bodies**

Pigment mottling**

Geographic atrophy

Slow/gradual vision loss

One or both eyes

19
Q

Wet or Dry ARMD:
Subretinal neovascular degeneration

Subretinal fluid or blood**

Fibrosis/scarring

RAPID vision distortion

Loss of central vision

Usually just one eye

20
Q

What is the management of macular degeneration?

Study These Flashcards
A

Vitamins (antioxidants/zinc)

Omega 3 FA’s

STOP SMOKING

Daily Amsler grid checks

Photocoagulation, photodynamic therapy, intravitreal steroid/monoclonal antibodies

21
Q

What are the two types of retinal detachment?

Study These Flashcards
A

Rhegmatogenous

Nonrhegmatogenous

22
Q

Which type of retinal detachment:

Posterior vitreous detachment

Traumatic retinal detachment

Study These Flashcards
A

Rhegmatogenous

23
Q

Which type of retinal detachment:

Traction retinal detachment

Associated with diabetes

Exudative (rare)

Study These Flashcards
A

nonrhegmatogenous

24
Q

What is the presentation of retinal detachment?

Study These Flashcards
A

Curtain-like vision loss **

Painless

Floaters

Photopsias (light flashes)

Loss of vision

May be peripheral only

Raised whitish retina

25
What should you do if you have a patient with only one retinal detachment?
Check the other eye! It is bilateral 20% of the time
26
How do you manage retinal detachment/
Refer to ophthalmology Medical: laser/cryo surgery Surgery: scleral buckle/vitrectomy
27
Name it: Arteriolar narrowing “copper wiring” Arteriolar sclerosis “silver wiring” AV nicking Retinal hemorrhage’s Retinal edema/exudates Disc edema
Hypertensive retinopathy
28
How do you manage hypertensive retinopathy?
Control BP Refer to ophthalmology if severe and they have vision loss
29
What are the two types of diabetic retinopathy?
Non-proliferative Proliferative
30
Name it: Blurred vision Hard Exudates (microaneurysms) Retinal hemorrhage Retinal edema Macular edema Cotton-wool spots Venous dilation
Non-proliferative Diabetoic retinopathy
31
Name it: Neovascularization Preretinal and vitreous hemorrhage Subsequent fibrosis Traction retinal detachment Macular edema: retinal thickening and edema invloving the macula
Proliferative diabetic retinopathy
32
Which type of diabetic retinopathy is worse?
Proliferative
33
How do you manage diabetic retinopathy?
Control blood sugar Refer to ophthalmology Laser photocoagulation (stops bleeding) Vitrectomy
34
What are the two types of retinal vascular occlusion?
Central retinal artery occlusion Central retinal vein occlusion
35
Name the type of retinal vascular occlusion: Emboli Total painless loss of vision “black as night” no light perception Afferent pupillary defect Whitening of retina “Cherry red spot”
Central retinal artery occlusion
36
Name the type of retinal vascular occlusion: Thrombotic Variable, painless loss of vision +/- afferent pupillary defect “Blood and thunder” retinal appearance
Central retinal vein occlusion
37
How do you manage central retinal artery occlusion?
No effective treatment Evaluate etiology to prevent future strokes - carotid plaques, cardiac thrombi Poor prognosis
38
How do you manage central retinal vein occlusion?
Aspirin Observation Treatment for retinal edema or ischemia Evaluate etiology if the pt is young...why did they get a clot? Severe hypertension, hypercoagulable state
39
What causes optic neuritis?
Demyelination of the optic nerve
40
How does optic neuritis present?
Monocular vision loss over hours to days Central scotoma +/- abnormal color vision +/- flashes of light +/- visible papillitis (inflammation of optic disc) with disc swelling
41
How do you manage optic neuritis?
MRI brain and orbits to look for signs of MS “white matter” IV Methylprednisolone for sever vision loss or 2+ white matter lesions on MRI (faster recovery, but does not impact long term vision) No treatment- improve in 2-3 weeks and will have 20/40 vision by one year
42
What is the prognosis of optic neuritis?
30% will have Multiple Sclerosis at 5 years ~demyelination~

Clin Med Exam 2 (Lauren) (6 decks)

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