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Surg Spec (Ophthalmology) > Visual Loss > Flashcards

Visual Loss Flashcards

(58 cards)

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1
Q

What is the most common type of cataract?

A

Nuclear

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2
Q

What type of cataract is caused by steroid use?

A

Subcapsular

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3
Q

Which pathology typically presents with a gradual decline in vision which cannot be corrected with glasses, as well as problems with glare, faded colour vision and halos around lights?

A

Cataract

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4
Q

What is the main feature that will be seen on examination of someone with a cataract?

A

Absence of or reduced red reflex

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5
Q

How are cataracts treated?

A

Phaco-emulsification with intra-ocular lens implantation

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6
Q

After cataract surgery, patients should be given which eye drops 4x daily for 1 month?

A

Chloramphenicol and prednisolone 1%

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7
Q

What is the commonest cause of blindness in the western world in > 65s?

A

ARMD

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8
Q

Any macular problem typically leads to the formation of what symptoms?

A

Central scotoma, blurred vision and metamorphopsia

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9
Q

The development of what feature in individuals with dry ARMD can indicate progression from dry to wet form and requires urgent opthalmological assessment?

A

Metamorphopsia

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10
Q

What are the main risk factors for ARMD?

A

Increasing age, family history and smoking

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11
Q

What is the main feature of dry ARMD seen on fundoscopy?

A

Drusen

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12
Q

Which pathology typically presents with a slow, progressive drop in central visual actuity?

A

Dry ARMD

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13
Q

There is currently no active treatment for dry ARMD, what is some advice that is given to patients?

A

Smoking cessation, eat more green leafy veg, blind registration and use of visual aids

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14
Q

Which pathology typically presents with a fairly sudden devastating drop in central visual acuity and associated metamorphopsia?

A

Wet ARMD

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15
Q

What investigation is used for identification and monitoring of wet ARMD?

A

Ocular coherence tomography (OCT)

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16
Q

How is wet ARMD treated?

A

Intra-vitreal anti-VEGF injections

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17
Q

What is the commonest cause of treatable blindness in the working age population?

A

Diabetic retinopathy

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18
Q

What are the 3 main categories of diabetic retinopathy?

A

No retinopathy, non-proliferative retinopathy (mild/moderate/severe), proliferative retinopathy

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19
Q

How are patients with no retinopathy or mild non-proliferative retinopathy treated?

A

Screen again in 12 months

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20
Q

How are patients with moderate non-proliferative retinopathy treated?

A

Screen again in 6 months

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21
Q

How are patients with severe non-proliferative retinopathy treated?

A

Referral to ophthalmology

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22
Q

How are patients with proliferative retinopathy treated?

A

Urgent referral to ophthalmology

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23
Q

What is the definitive treatment for any symptomatic non-proliferative retinopathy and any proliferative retinopathy?

A

Laser treatment

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24
Q

Diabetic maculopathy should only be treated when there is reduced vision. What treatment is used?

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A

Anti-VEGF and sometimes focal laser treatment

25
When must the DVLA be informed of an individual undergoing laser eye treatment?
If the individual has undergone laser eye treatment in both eyes
26
What features on fundoscopy classify mild non-proliferative diabetic retinopathy?
1 or more microaneurysm
27
What features on fundoscopy classify moderate non-proliferative diabetic retinopathy?
Microaneurysms, blot haemorrhages, hard exudates, cotton wool spots
28
For non-proliferative diabetic retinopathy to be classified as severe, there must be blot haemorrhages and microaneurysms in how many quadrants?
All 4
29
For non-proliferative diabetic retinopathy to be classified as severe, there must be venous beading in how many quadrants?
At least 2
30
For non-proliferative diabetic retinopathy to be classified as severe, there must be intraretinal microvascular abnormalities (IRMA) in how many quadrants?
At least 1
31
What is the main feature of proliferative diabetic retinopathy?
Retinal neovascularisation
32
Retinal neovascularisation seen in proliferative diabetic retinopathy can lead to what complication?
Vitreous haemorrhage
33
Proliferative diabetic retinopathy is most commonly seen in individuals with which type of diabetes?
Type 1
34
Diabetic maculopathy is most common in individuals with which type of diabetes?
Type 2
35
Silver wiring is a feature seen on fundoscopy of which pathology?
Hypertensive retinopathy (stage I)
36
Cotton wool exudates and flame and blot haemorrhages are features of which stage of hypertensive retinopathy?
Stage III
37
What is the feature suggestive of stage IV hypertensive retinopathy?
Papilloedema
38
What is the main feature of glaucoma on fundoscopy?
Increased cup to disc ratio
39
What are the 4 different pharmacological treatment options that can be used for chronic open angle glaucoma?
Prostaglandins, beta blockers, carbonic anhydrase inhibitors, parasympathomimetics
40
What is the definitive surgical management for chronic open angle glaucoma?
Trabeculectomy
41
Which pathology typically presents with a sudden, profound, painless visual loss and a relative afferent pupillary defect?
Central retinal artery occlusion
42
Which pathology will cause a pale, swollen retina with a cherry red spot at the macula?
Central retinal artery occlusion
43
Methods to try and dislodge the clot can be used if an individual with a CRAO presents within what timeframe?
90 minutes
44
Which pathology presents with a transient painless visual loss 'like a curtain coming down', which lasts around 5 minutes with a full recovery?
Amourosis fugax (transient CRAO)
45
Which pathology presents with a moderate-severe visual loss and relative afferent pupillary defect?
Central retinal vein occlusion
46
Which pathology will show retinal flame haemorrhages and torturous vessels on fundoscopy?
Central retinal vein occlusion
47
Which pathology is more commonly seen in diabetics, those with bleeding disorders or those taking anti-coagulants and presents with a loss of vision and the presence of floaters?
Vitreous haemorrhage
48
Which pathology presents with flashers, floaters and a dark shadow in the peripheral vision which is increasing in size?
Retinal detachment
49
Is retinal detachment more common in those who are short sighted or long sighted?
Short sighted (myopic)
50
Which pathology results in a variable loss of vision, usually over a few days, washed out colours (red desaturation) and a dull ache behind the eye on movements?
Optic neuritis
51
Most cases of optic neuritis will resolve spontaneously within how long?
4 weeks
52
Is acute angle closure glaucoma more common in those who are short sighted or long sighted?
Long sighted (hypermetropic)
53
Which pathology presents with severely reduced visual acuity, pain +/- nausea/vomiting?
Acute angle closure glaucoma
54
Which pathology causes a red eye, cloudy/hazy cornea, fixed mid-dilated pupil?
Acute angle closure glaucoma
55
What is the first, non-pharmacological treatment that can be done for acute angle closure glaucoma?
Lie the patient flat
56
What topical drops are given to patients with acute angle closure glaucoma?
Anti-hypertensives, steroids and pilocarpine
57
What IV treatment can be given to patients with acute angle closure glaucoma?
Acetazolamide
58
What is the definitive treatment for acute angle closure glaucoma?
YAP laser peripheral iridotomy

Surg Spec (Ophthalmology) (3 decks)

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