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Flashing lights, floating spots (black or red), field loss like curtain coming in from periphery. diagnosis?
acute retinal detachment
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what happens to the affected pupil in acute retinal detachment in response to light?
dilates due to RAPD
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sudden loss of vision in part of the visual field, retinal haemorrhages, dilated retinal veins, CWS. diagnosis?
branch retinal vein occlusion
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sudden painless loss of vision with pale retina?
retinal artery occlusion
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in retinal artery occlusion, what is the feature in the centre of macular?
cherry red spot (sign of ischaemia)
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what is amaurosis fugax?
severe temporary visual los due to a transient lack of blood supply to retina or visual cortex
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give 2 causes of amaurosis fugal?
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what is the commonest cause of visual loss in elderly?
ARMD
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give 2 causes of acute optic neuropathy?
- MS
- atherosclerosis - ischaemia
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in acute optic neuropathy, describe the visual loss
- rapidly progressive
- decreased colour visa
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spontaneous appearance of blood between sclera and conjunctiva. diagnosis? and causes
- subconjunctival haemorrhage
- trauma, rubbing, severe coughing
- HTN, clotting disorder
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mild eye irritation and redness, SUPERFICIAL. diagnosis? what is this assoc. with?
- episcleritis
- collagen vascular disorders - RA
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what is blepharitis? symptoms
- chronic inflammation of eyelid margin
- loss of lashes, different sizes
- crusting at eyelid margins and gritty sensation in eye
- caused by staph and acne rosacea
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history of pain, FB sensation, blurred vision, photophobia. diagnosis? and where would redness be?
- corneal ulcer
- max red around cornea
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pain, rainbow like haloes around lights, nausea, vomiting, dull deep periocular headache. diagnosis? what would pupils be like?
- acute angle closure glaucoma
- pupils semi dilated, not reactive to light
-
what are the 3 features of acute angle closure glaucoma OE?
- ciliary hyperaemia
- corneal oedema
- dilated pupil
-
mild to severe eye pain, radiates to ear, forehead. DEEP DULL pain, wakes patient at night. diagnosis? Rx?
- scleritis
- happens in vasculitis
- Rx: oral nsaid or steroids if severe
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blurred vision, photophobia, watery eye, pain if severe, redness in limbus. diagnosis? cause? pupil shape and reason?
- anterior uveitis (iritis)
- autoimmune disease e.g. sarcoid, behcets, seroneg spondylarthropathies
- pupils: small and fixed due to adhesions between anterior lens and pupil margin
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if you see keratin precipitates and hypopyon what are these a feature of? how do you treat this?
- anterior uveitis
- Rx: topical steroids BUT rule out corneal ulcer by fluorescein dye test first
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infection of eyeball after eye surgery, blurred vision painful eye, photophobia, floaters. diagnosis? Rx
- endophthalmitis
- Rx: inject abx, surgical vitrectomy
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what are the features of grade I hypertensive retinopathy?
tortuous arteries, thick shiny walls (silver wiring)
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what are the features of grade II hypertensive retinopathy?
AV nipping where artery crosses vein as artery becomes thick
-
what are the features of grade III hypertensive retinopathy?
flame haemorrhages and CWS
-
what are the features of grade IV hypertensive retinopathy?
papilloedema (bilateral disc swelling due to increased ICP, veins congested)
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if there is redness most marked around cornea, what is this diagnosis?
anterior uveitis
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if there is a red eye and dilated pupil, diagnosis?
acute glaucoma
-
if there is a red eye and small pupil, diagnosis?
anterior uveitis
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what are the features of background DR?
- HEM
- haemorrhages - blots
- exudates (hard) - lipid deposits
- microaneurysm - dots
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what are features of pre-proliferative DR?
- microaneurysm
- haemorrhages
- exudates
- cotton wool spots
- venous beading
- (all signs of retinal ischaemia)
- REFER TO SPECIALIST
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what are features of proliferative DR?
- new vessels - disc or elsewhere
- haemorrahges
- URGENT referral
-
in DR, when is it necessary to refer to ophthalmologist? (4)
- background with macular changes
- background with decreased vision
- pre-prolif
- proliferative
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what happens to the lens in cataract?
loss of transparency of crystalline lens
-
what are the causes of cataract?
- age
- diabetes
- htn
- trauma
- SE of steroids
- uveitis
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what is the Rx of cataract?
- remove when interfere with ADL
- put intraocular lens in
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what are the fundoscopy features of glaucoma?
cup:disc ratio increases
-
what are the 2 main categories of AION (anterior ischaemic optic neuropathy)?
- arteritis: related to GCA, PMR, older pts
- non arteritis: younger, high BP, DM, hypermetropia
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what are the fundoscopy features and visual acuity of AION?
- pale disc
- swelling around edges
- vision: only perception of light so need to Rx fast
-
what happens to vision in retinal vein occlusion?
sudden painless loss of vision
-
what are the fundoscopy features of retinal vein occlusion?
- stormy sunset look
- engorged veins with haemorrhages
-
what are the visual features of ARMD?
- untreatable visual loss in elderly
- CENTRAL visual loss
- distorted and blurred vision
-
what are the fundoscopy features of dry ARMD?
drusen: nodules in choroid
-
what are the fundoscopy features of wet ARMD?
- damage in macular, haemorrage
- unusual pigmentation at macula
-
what is the Rx of wet ARMD?
anti-VEGF injection Ranibizumab
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