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Y2 OPHTHALMOLOGY > Visual Loss > Flashcards

Visual Loss Flashcards

(50 cards)

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1
Q

List the main causes of sudden visual loss

A 
Vascular - ischaemic optic neuropathy
Vitreous haemorrhage
Retinal detachment
Wet age-related macular degeneration
Closed-angle glaucoma
Optic neuritis
Stroke
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2
Q

What are the 2 main branches of the ophthalmic artery?

A

Central retinal artery

Posterior ciliary artery

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3
Q

Which part of the retina does the central retinal artery supply?

A

Inner 2/3 (including ganglion cells)

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4
Q

Which part of the retina does the posterior ciliary artery supply?

A

Outer 1/3 (photoreceptors, pigment layer)

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5
Q

Visual loss caused by central retinal artery occlusion is associated with pain. True/False?

A

False

Painless unless assoc. with GCA

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6
Q

Relative afferent pupillary defect is evident in central retinal artery occlusion. What is this?

A

When a light is shone on the right eye, the right eye constricts but the left eye dilates

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7
Q

Describe the appearance of the retina in central retinal artery occlusion

A 
Pale
Oedematous
Thread-like vessels
Swelling
NO BLOOD CAN GET INTO EYE
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8
Q

Outline ophthalmic management of central retinal artery occlusion within 24hrs

A

Ocular massage (try to convert CRAO into BRAO)

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9
Q

Outline vascular management of central retinal artery occlusion

A 
Carotid Doppler (establish source)
Manage risk factors
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10
Q

What is another name for transient central retinal artery occlusion?

A

Amaurosis fugax

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11
Q

Describe visual loss in amaurosis fugax

A

Transient/partial loss “like a curtain” that lasts up to 5mins with full recovery

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12
Q

Amaurosis fugax patients require immediate referral to which clinic? What medication should be prescribed?

A

TIA clinic

Aspirin

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13
Q

List causes of central retinal vein occlusion

A

Atherosclerosis
Hypertension
Hyperviscosity
Raised intra-ocular pressure

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14
Q

How does atherosclerosis cause central retinal vein occlusion?

A

Arterial thickening presses on vein to cause altered blood flow, resulting in stasis and occlusion

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15
Q

Describe the appearance of the retina in central retinal vein occlusion

A 
Haemorrhages
Dilated, tortuous veins
Disc swelling
Macular swelling
NO BLOOD CAN GET OUT OF EYE
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16
Q

Which growth factor may be suppressed as part of treatment for central retinal vein occlusion? What is the other management?

A

VEGF (anti-VEGF drugs)
Manage risk factors
Monitor for complications

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17
Q

The retina appears pale in central retinal artery occlusion and dark in central retinal vein occlusion. True/False?

A

True

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18
Q

Give another name for occlusion of the optic nerve head. Describe the appearance of the retina.

A

Ischaemic optic neuropathy

Pale swollen disc

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19
Q

Describe the pathogenesis of ischaemic optic neuropathy

A

Posterior ciliary arteries become occluded which results in infarction of the optic nerve head

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20
Q

What are the 2 types of ischaemic optic neuropathy?

A

Arteritic (painful, inflammation, GCA)

Non-arteritic (painless, atherosclerosis)

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21
Q

What are the 4 stages of visual loss, defined by testing?

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A

Snellen chart
Counting fingers
Directional hand movement
Perception of light

22
Q

Blindness in giant cell arteritis is irreversible. True/False?

23
Q

List clinical features of giant cell arteritis

Study These Flashcards
A 
Jaw claudication
Pulsating temporal artery
Temporal headache
Visual loss
Tender scalp (notice when combing hair)
Malaise
24
Q

List clinical signs of a vitreous haemorrhage

Study These Flashcards
A

Sudden visual loss
Floaters
Loss of red reflex

25
How is a vitreous haemorrhage managed?
Identify + treat cause | Vitrectomy for non-resolving cases
26
List clinical features of retinal detachment. How does the retina appear? What is the management?
``` Painless visual loss Flashes of light, floaters Relative afferent pupil defect Tear on ophthalmoscopy Surgical ```
27
What is the commonest cause of blindness in the Western world in patients over 65?
Age-related macular degeneration (ARMD)
28
What is the difference between the two types of ARMD?
Wet - sudden visual loss | Dry - gradual visual loss
29
Describe the pathogenesis of wet ARMD
Angiogenesis under the retina with leakage/build up of fluid causing scarring
30
Describe the appearance of the retina in wet ARMD. What is the main clinical symptom described?
Metamorphopsia causing distortion Haemorrhage/ exudate Rapid central loss of vision
31
Outline management of wet ARMD
OCT Laser and PDT (traditionally) Anti-VEGF injection (nowadays)
32
List the main causes of gradual visual loss (CARDIGAN)
``` Cataract ARMD (dry) Refractive error Diabetic retinopathy Inherited diseases Glaucoma Access to eye-clinic is Non-urgent ```
33
What is cataract? What are the clinical features?
Clouding of the lens Gradual hazy/blurred loss of vision Can't be reduce with glasses Glare
34
Outline management of cataract
Surgical removal with intra-ocular lens implant if patient is symptomatic
35
Drusen may be seen in dry ARMD. What is this? What are the other clinical features
``` Waste products (yellow fat/protein deposits) below retinal pigment epithelium Gradual appearance of central scotoma (central LOV) ```
36
There is no cure for dry ARMD. True/False?
True | Supportive vision aids may help
37
What is meant by refractive error?
Eye cannot clearly focus image
38
What is myopia?
"Short-sightedness" | Light focuses in front of the retina (need a - lens)
39
What is hypermetropia?
"Long-sightedness" | Light focuses behind the retina (need a + lens)
40
What is astigmatism?
Eye is shaped like a rugby ball as opposed to a football | Irregular corneal curvature
41
What is presbyopia?
Loss of visual accommodation with age (inability to focus on near objects due to stiff lens - need a + lens)
42
What is glaucoma?
Progressive optic neuropathy, probably cause by raised IOP and fluid build-up
43
Which type of glaucoma is an ophthalmic emergency - open or closed -angle?
Closed-angle
44
List clinical features of closed-angle glaucoma
Painful red eye Visual loss Headache Nausea, vomiting
45
Describe the appearance of the optic disc in glaucoma
Cupped disc
46
Describe the pathogenesis behind closed angle glaucoma
Aqueous humour increases in pressure due to iris/ lens resistance which obstructs the trabecular meshwork
47
Outline management for glaucoma
Drops/ oral meds | Laser iridotomy
48
Describe the pathogenesis of cataracts
Glucose converts to sorbitol which exerts osmotic effect to draw fluid in
49
Open angle glaucoma is usually asymptomatic. True/ False?
True`
50
Describe the pathogenesis behind open angle glaucoma
Angle is open but resistance to outflow of aqueous in trabecular meshwork

Y2 OPHTHALMOLOGY (11 decks)

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