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2MB Ophthalmology > Visual Loss > Flashcards

Flashcards in Visual Loss Deck (45)
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1

List the main causes of sudden visual loss

Vitreous haemorrhage
Retinal detachment
Wet age-related macular degeneration
Closed-angle glaucoma
Optic neuritis
Stroke

2

What are the 2 main branches of the ophthalmic artery?

Central retinal artery
Posterior ciliary artery

3

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

Inner 2/3 (including ganglion cells)

4

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

Outer 1/3 (photoreceptors, pigment layer)

5

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

False
Painless unless assoc. with GCA

6

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

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

7

Describe the appearance of the retina in central retinal artery occlusion

Pale
Oedematous
Thread-like vessels
Swelling

8

Outline ophthalmic management of central retinal artery occlusion within 24hrs

Ocular massage (try to convert CRAO into BRAO)

9

Outline vascular management of central retinal artery occlusion

Carotid Doppler (establish source)
Manage risk factors

10

What is another name for transient central retinal artery occlusion?

Amaurosis fugax

11

Describe visual loss in amaurosis fugax

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

12

Amaurosis fugax patients require immediate referral to which clinic?

TIA clinic

13

List causes of central retinal vein occlusion

Atherosclerosis
Hypertension
Hyperviscosity
Raised intra-ocular pressure

14

How does atherosclerosis cause central retinal vein occlusion?

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

15

Describe the appearance of the retina in central retinal vein occlusion

Haemorrhages
Dilated, tortuous veins
Disc swelling
Macular swelling

16

Which growth factor may be suppressed as part of treatment for central retinal vein occlusion?

VEGF

17

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

True

18

Give another name for occlusion of the optic nerve head

Ischaemic optic neuropathy

19

Describe the pathogenesis of ischaemic optic neuropathy

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

20

What are the 2 types of ischaemic optic neuropathy?

Arteritic (painful, inflammation, GCA)
Non-arteritic (painless, atherosclerosis)

21

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

Snellen chart
Counting fingers
Directional hand movement
Perception of light

22

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

True

23

List clinical features of giant cell arteritis

Jaw claudication
Pulsating temporal artery
Headache
Visual loss
Tender scalp
Malaise

24

List clinical signs of a vitreous haemorrhage

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

Painless visual loss
Flashes of light, floaters
Relative afferent pupil defect

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

30

Describe the appearance of an Amsler grid showing wet ARMD

Missing boxes = blind spot
Distorted lines = metamorphopsia (wavy lines)