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Year 4 - Ophthalmology > Visual loss > Flashcards

Visual loss Flashcards

1
Q

visual loss can be sudden or gradual, give sudden causes

A 
vascular occlusion 
vitreous haemorrhage 
retinal detachment 
wet ARMD
closed angle glaucoma 
optic neuritis 
stroke
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2
Q

visual loss can be sudden or gradual, give gradual causes

A 
cataracts 
dry ARMD
open angle glaucoma 
refractive errors
diabetic retinopathy
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3
Q

what is the main arterial supply to the eye and what does it branch from

A

ophthalmic artery from the internal carotid artery

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4
Q

what are the branches of the ophthalmic artery and what do they supply

A

posterior ciliary arteries - head of optic nerve

central artery of the retina - inner 2/3rd retina

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5
Q

what is CRAO

A

central retinal artery occlusion

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6
Q

symptoms of CRAO

A

painless sudden loss of vision

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7
Q

signs of CRAO

A

RAPD
pale oedematous retina
cherry red spot at fovea
thin vessels

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8
Q

causes of CRAO

A

stroke
carotid artery disease
thromboembolic

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9
Q

types of CRAO

A

central
branch
amaurosis fugax

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10
Q

what is amaurosis fugax

A

transient CRAO
visual loss like a ‘curtain coming down’
no abnormalities on examination - rely on history
urgent stroke referral

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11
Q

what is CRVO

A

central retinal vein occlusion

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12
Q

symptoms of CRVO

A

sudden visual loss

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13
Q

CRVO is associated with Virchow’s triad, what are the elements of this

A

hypercoaguability
stasis
endothelial damage

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14
Q

signs of CRVO

A

retinal haemorrhages
dilated tortuous veins
swelling of disc and macula - oedematous
cotton wool spots = infarcts of nerve fibre layer

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15
Q

buzzword description of CRVO appearance

A

cheese on toast appearance

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16
Q

types of CRVO

A

central

branch

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17
Q

what is ischaemic optic neuropathy

A

occlusion of optic nerve head

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18
Q

what vessel is occluded in ischaemic optic neuropathy

A

posterior ciliary arteries

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19
Q

causes of ischaemic optic neuropathy

A

GCA

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20
Q

symptoms of ischaemic optic neuropathy

A

sudden visual loss
may be irreversible
GCA symptoms - headache, jaw claudication, scalp tenderness…

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21
Q

management of GCA with ocular involvement

A

high dose steroids ASAP

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22
Q

causes of intra ocular haemorrhage

A

diabetic retinal ischaemia
CRVO
Hypertensive disease

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23
Q

what do you call bleeding into the vitreous cavity

A

vitreous haemorrhage

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24
Q

signs and symptoms of vitreous haemorrhage

A

sudden loss of vision
floaters
loss of red reflex
haemorrhages on fundoscopy

25
features of optic neuritis
painful loss of vision associated with MS RAPD reduced colour vision
26
pathology behind retinal detachment
vitreous gel becomes more like liquid and collapses in on itself pulling and tearing the retina away resulting in a mechanical separation of sensory retina from pigmented epithelium
27
symptoms of retinal detachment
sudden painless loss of vision | sudden onset flashers and floaters
28
signs of retinal detachment
RAPD | may see detachment
29
risk factors for ARMD
smoking age genetics diet
30
in wet ARMD, which is lost first, central or peripheral vision
central vision is lost first
31
pathology behind wet ARMD
neovascularisation under retina | new vessels are fragile and leaky and so can bleed under the retina
32
symptoms of wet ARMD
rapid central visual loss | distortion aka metamorphopsia
33
signs of wet ARMD
haemorrhages exudate drusen
34
what is glaucoma
progressive optic neuropathy usually from raised intra ocular pressure from build up of aqueous humour
35
symptoms of closed angle glaucoma
``` painful red eye severe headache N+V cloudy cornea dilated pupil peripheral vision lost first ```
36
in closed angle glaucoma, which is lost first, central or peripheral vision
peripheral vision is lost first
37
features of gradual visual loss
bilateral | asymmetrical
38
CARDIGAN mneumonic for gradual visual loss
``` cataracts ARMD dry refractive error diabetic retinopathy inherited glaucoma - open angle Access is Non urgent ```
39
what are cataracts
cloudiness of lens from build up of proteins | there are many different types
40
what investigation should be done in all babies to rule out congenital catarcts
red reflex
41
symptoms of cataracts
gradual loss of vision uncorrected by glasses | glare from TV or street signs/lights
42
management of cataracts
phacoemulsification and lens replacement surgery
43
pathology behind dry ARMD
build up of drusen around macula which interrupts nutrient exchange damaging the retina
44
symptoms of dry ARMD
gradual loss of vision | central vision missing - scotoma
45
signs of dry ARMD
drusen | atrophic patches of retina
46
what can you do to fix refractive error
get glasses
47
features of open angle glaucoma
asymptomatic, found on screening cupped optic disc (bigger cup, greater damage) loss of peripheral vision raised IOP
48
what is the difference between a swollen optic disc and papilloedema
swollen optic disc can be from any cause | papilloedema is a swollen disc secondary to only raised ICP
49
what should you suspect in patients with bilateral optic disc swelling
raised ICP due to SOL
50
what is the normal ICP range
5-15mmHg
51
the optic nerve is an extension of the brain and so is covered by the 3 layers of meninges, true or false
true
52
what 3 components influence the ICP
brain blood CSF
53
what happens as a consequence of chronic optic disc swelling
optic atrophy atrophic and pale looking disc visual loss --> blindness
54
if there is horizontal visual loss, the vascular defect is infront/behind the optic chiasm
infront
55
if there is vertical visual loss, the vascular defect is infront/behind the optic chiasm
behind
56
causes of CRVO
``` hypertension raised cholesterol myeloma - hyperviscosity inflammation Virchows triad ```
57
management of wet ARMD
anti VEGF intra vitreal injections
58
management of closed angle glaucoma
miopics and iridotomy with laser therapy

Year 4 - Ophthalmology (12 decks)

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