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Opthalmology > Visual loss > Flashcards

Flashcards in Visual loss Deck (20):
1

What are the causes of papilloedema?

Increased intercranial pressure
- space occupying lesion
- mailigant hypertension
-Hydrocephalus
- hypercapnia

2

What is Holmes-adie pupil?

Benign dilated pupil (80% are unilateral).

3

How does vitreous haemorrhage present?

Sudden onset floaters in vision
Reddish tint to vision
Reduced red reflex
Recused visual acuity

Rx- exclude retinal detachment (uss)
Identify cause and treat abnormal vessels

4

Whats the presentation of posterior vitreous detachment?

Acute onset floaters
Photopsia (flashing lights)
Ring of floaters/ hairs in the temporal side of central vision.
Normal visual acuity and fields

Rx- none

5

How does retinal detachment present?

Curtain over vision
Straight lines appear curved (+ve amsler grid test)
Shadows move from peripheral vision to central vision

Rx- repair hole (or drain sub-retinal fluid),

6

How is retinal detachment treated?

Holes treated with laser or cryotherapy
Retina Reattached by drainage of sub-retinal fluid and scleral buckle

7

How does retinal artery occlusion present?

(Usually caused by atherosclerosis)
Sudden painless of vision
Can be temporary (amaurosis fugax)
Fundoscopy 'cherry red spots' (ischemic retina)
Afferent pupillary defect

Rx- branch supportive treatment
Central - reduce intraoccular pressure, CO2 rebreathing (vasodilation)

8

How does retinal vein occlusion present?

Often in pts. With hypertension or hyper viscosity (eg DM, myeloma, smoking)

On examination - flame haemorrhages, dilated tortuous vessels, swollen optic disc, cotton wool spots, RAPD-ischemic.

9

How does atrophic macular degeneration present?

Dry with 'drusen'

Currently no treatments. Just stop smoking and take high dose vitamins.

10

How does exudative macular degeneration present?

Wet/ neovascular.
Choroidal neovascularisation
Sudden distrubance of central vision

Ix- fundus fluorescein angiogram
Rx - intravitrial anti-VEGF (eg ranibizumab), photocoagulation, photodynamic therapy

11

What is the leading cause of visual loss in the elderly?

Age related macular degeneration

12

How does giant cell arteritis/ temporal arteritis present?

Impaired visual acuity 2' to anterior ischemic optic neuropathy.
Tender scalp, headache, neck ache,
Jaw cladication
Mailaise, weight loss
Proximal myopathy

Ix- ESR, CRP, temporal artery biopsy.
Rx- high dose steroids,

13

How does optic neuritis present?

Unilateral swollen disc
Reduced vision
RAPD (relative afferent pupillary defect)

Think: multiple sclerosis (demyelinating inflammation)

14

What is a relative afferent pupillary defect?

Non symmetrical response to the swinging light test
Therefore a defect is shown

15

Transient disturbance in colour vision?

Optic neuritis (often MS)

16

Pale retina causes?

Retinal artery occlusion

With red spot

17

In a stroke with homonymous hemianopia in the defect contralateral or ipsilateral to the brain lesion?

Contralateral (same side effected as body)

Eg right weakness = right side HH

18

Causes of central rential vein occulsion

Glaucoma
Polycythemia
Hypertension
Increases with age

19

Causes of central retinal artery occulsion

Thromboembolism - eg atherosclerosis

Arteritis - eg temporal arteritis

20

Stages of hypertensive retinopathy

1- tortuous vessels and silver wiring (increased light reflex)
2- av nipping
3- cotton wool spots and flame and blot haemorrhages
4- papillodema