Vision Loss - Vitreous Causes

Question 1

Vitreous haemorrhage is bleeding into the vitreous humour. It is one of the most common causes of sudden painless loss of vision. What is the incidence of this?

1 - 7 cases per 100,000
2 - 70 cases per 100,000
3 - 700 cases per 100,000
4 - 7000 cases per 100,000

Answer 1

1 - 7 cases per 100,000

Equally as likely in men and women

Question 2

What age does Vitreous haemorrhage typically peak at?

1 - >40
2 - >50
3 - >60
4 - >70

Answer 2

4 - >70

Question 3

Which of the following is NOT a typical cause of Vitreous haemorrhage?

1 - Diabetic retinopathy
2 - Autoimmune conditions
3 - Retinal tear or detachment
4 - Retinal vein occlusion
5 - Trauma:
6 - Age-related macular degeneration
7 - Posterior vitreous detachment
8 - Tumours

Answer 3

2 - Autoimmune conditions

Most commonly this will be a diabetic patient who has had a previous vitreous haemorrhage secondary to proliferative diabetic retinopathy

Question 4

Vitreous haemorrhage can cause sudden loss of vision. Is this typically associated with pain?

Answer 4

• no

The vision loss is painless

Question 5

In addition to vision loss, which 2 of the following do patients typical describe in vitreous haemorrhage?

1 - photopsia
2 - floaters
3 - hazy vision
4 - distorted vision

Answer 5

2 - floaters
3 - hazy vision

Question 6

What imaging modality can be used to ensure there is no retinal detachment in a patient with suspected vitreous haemorrhage?

1 - CT
2 - MRI
3 - ultrasound
4 - PET scan

Answer 6

3 - ultrasound

Question 7

What is the standard treatment for vitreous haemorrhage?

1 - surgery (vitrectomy)
2 - wait and see
3 - laser therapy
4 - steroids and lubricating drops

Answer 7

1 - surgery (vitrectomy)

Locate the tear in the vitreous and identify the cause

Question 8

Subhyloid haemorrhage is another acute condition that can cause vision loss. Where does the subhyloid haemorrhage occur?

1 - between macula and fovea
2 - between vitreous and retina
3 - between lens and sclera
4 - between sclera and retina

Answer 8

2 - between vitreous and retina

Question 9

Which condition can subhyloid haemorrhage occur in more than others?

1 - sarcoidosis
2 - lupus
3 - COPD
4 - diabetes

Answer 9

4 - diabetes

Normally following neovascularisation

Diabetic patients will need laser therapy to stop neovascularisation

Question 10

In children, which 2 of the following are the most common causes of a lack of red light refelex?

1 - cataracts
2 - glaucoma
3 - retinoblastoma
4 - carotid cavernous fistula

Answer 10

1 - cataracts
3 - retinoblastoma

Question 11

Can a squint in a child affect their vision as the child grows up?

Answer 11

• yes
  Can cause a lazy eye

Needs to be addressed and treated to reduce this risk