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32 Cards in this Set
- Front
- Back
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SXS of Vitreous Hemorrhage include
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Blurry Vision
"Floaters" |
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Ocular exam abnormalities related to vitreious hemorrhage include
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VA: Reduced in proportion to amount of blood
RAPD: NO Fields: Normal to reduced Fundus: Decreased red reflex, poor visualization |
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Causes of vitreous hemorrhage include ...
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Retinal tears
Retinal neovascularization 2ary to DM, Sickle Cell Subarachnoid Hemorrhage Valsalva |
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SXS of retinal detachment include ...
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Flashes
Floaters Shade over field of vision Visual Loss PAINLESS |
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Pertinent Exam findings in retinal detachment include
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VA: Reduced if macula involved
RAPD: Not usually unless extensive Fields: Diminished in field OPPOSITE the detachment IOP: reduced Fundus: elevated retina often with folds |
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SXS of Central Retinal Artery Occlusion
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Sudden, PAINLESS and severe visual loss
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OE findings in CRAO
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VA: Severely reduced unless fovea spared
RAPD: YES FIelds: Generalized loss Fundus: Vascular stasis, "boxcarring", cherry-red spot |
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TX of CRAO includes
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OCULAR EMERGENCY!!!
Ocular massage Lower IOP via anterior chamber paracentesis Thrombolytic therapy |
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Pts presenting with CRAO should also be worked up for what?
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STroke and giant cell arteritis in elderly
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SXS of Branch Retinal Artery Occlusion
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UNILATERAL painless visual disturbance or loss, central or peripheral
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OE findings in BRAO
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VA: Reduced if macula involved
RAPD: not usually Fields: diminished in field OPPOSITE affected retina |
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The visual loss in BRAO may be _______; _____ should also be worked up
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transient, also known as amaurosis fugax
Stroke |
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SXS of central retinal vein occlusion
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SUBacute, painless visual loss
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OE findings in CRVO
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VA: moderately to severely reduced
RAPD: if severe Fields: generalized loss Fundus: diffuse hemorrhages, disc swelling, dilated toruous veins |
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CRVO often occurs in .....
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older pts with HTN and arteriosclerosis
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CRVO in a younger pt warrants a workup for _____
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hypercoagulable state
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What acute treatments improve vision in CRVO?
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none
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CRVO requires an opthalmic follow-up for _____
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neovascularization
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SXS of BRVO
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blind spot in field of vision
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OE findings in BRVO
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VA: normal to mildly reduced
RAPD: no Fields: sectoral field loss |
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SXS of optic neuritis
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visual loss associated with PAIN on eye movements. Occurs over hours to days; usually UNILATERAL
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OE findings in optic neuritis
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VA: mild to moderately reduced
RAPD: YES, even with mild loss of vision Fields: central, cecocentral, or altitudinal field loss Fundus: hyperemic disc swelling (papillitis) or nl appearance (retrobulbar optic neuritis) Abnormal color vision |
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Pts presenting with optic neuritis should be f/u for ...
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Neurology to r/o MS
MRI to look for enhancement of optic nerve or other demyelinating dz |
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Papilledema is
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bilateral optic disc swelling associated with increased ICP
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SXS of papilledema
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nl visual acuity
No RAPD Fields: enlarged blind spot Transient visual obscurations: bilateral visual loss that lasts only for a few seconds that occurs when rising from a head down position |
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SXS of anterior ischemic optic neuropathy
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Sudden painless unilateral vision loss
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OE findings in anterior ischemic optic neuropathy
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VA: mod to severely reduced
RAPD: YES Fields: altitudinal field loss Fundus: pale disc swelling with splinter hemorrhages Abnormal color vision |
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Potential cause of anterior ischemic optic neuropathy
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Giant cell arteritis
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Giant cell arteritis is associated with ..
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headaches
scalp tenderness jaw claudications PMR wt loss fever Elevated ESR, CRP |
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AION 2ary to giant cell arteritis should be immediately tx with
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prednisone to prevent loss in second eye
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Non-arteritic AION is associated with
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HTN, DM, CVD
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A nl eye exam including nl pupil reactions, but severe vision loss may be indicative of
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cortical blindness 2ary to occipital lobe damage
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