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17 Cards in this Set
- Front
- Back
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What should be asked about in the history of acute visual disturbance? |
Floaters Field loss Zigzag lines Flashing lights Headache Pain on moving eye |
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What should be examined when a patient complains of acute visual disturbance? |
Acuity Pupil reactions Appearance of retina, macula and optic nerve Red reflex Field loss |
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What does obstruction of the red reflex on ophthalmoscopy suggest? |
Vitreous haemorrhage (may have pre-existing cataract). |
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What is the commonest cause of acute onset of floaters? |
Posterior vitreous detachment. |
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What do flashing lights suggest (in combination with floaters)? |
Traction on the retina, causing posterior vitreous detachment/retinal detachment. |
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How is acute posterior vitreous detachment managed? |
Urgent, same day, ophthalmic assessment to identigy any retinal breaks. May require visit 1-2months later to exclude subsequent development of a retinal hole |
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How does vitreous haemorrhage present? |
Sudden onset floaters/blobs in vision. Visual acuity may be normal/reduced. Flashing lights indicate retinal traction and are a danger sign. |
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What does ophthalmology show in vitreous haemorrhage? |
Reduced red reflex. Clots of blood may move with the vitreous. |
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How is vitreous haemorrhage managed? |
Spontaneous resolval/vitrectomy. |
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How is visual acuity affected by retinal detachment? |
Normal if macula still attached, reduced to counting fingers/hand movements if not. |
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How is retinal detachment managed? |
Urgent referral. Small holes with no associated fluid under the retina can be treated with a laser (inflammatory reaction seals hole). True detachments usually require surgery to seal holes, reduce vitreous traction and drain fluuid if necessary. Victrectomy may be required, can be in combo with IA gases (e.g. sulphur hexafluoride) or silicone oil to keep the retina flat. If gas is used, the patient must lie face down for several weeks until most of the gas has been absorbed. |
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How does retinal arterial occlusion present? |
Sudden onset greyout of vision/descending curtain in one/both eyes. |
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Which arteries supply which parts of the retina? |
Retinal artery and its branches supply inner two thirds of neuroretina. Choroid artery supplies outer third. |
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What typically presents with sudden visual disturbance of central vision, where straight lines seem wavy, objects may seem distorted and central area of visual distortion or loss movesas the patient tries to look around it? |
Disciform macular degeneration |
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What typically presents in women aged 20-40 with disturbed vision in one eyeand pain that worsens on movement of the eye? |
Optic/retrobulbar neuritis |
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What are flame haemorrhages characteristic of? |
Venous occlusion |
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What do afferentpapillary defect and retinal cotton wool spots imply? |
Ischaemic, damaged retina (e.g. in venous occlusion). Poor prognostic sign. |
