Flashing lights, floating spots (black or red), field loss like curtain coming in from periphery. diagnosis? acute retinal detachment what happens to the affected pupil in acute retinal detachment in response to light? dilates due to RAPD sudden loss of vision in part of the visual field, retinal haemorrhages, dilated retinal veins, CWS. diagnosis? branch retinal vein occlusion sudden painless loss of vision with pale retina? retinal artery occlusion in retinal artery occlusion, what is the feature in the centre of macular? cherry red spot (sign of ischaemia) what is amaurosis fugax? severe temporary visual los due to a transient lack of blood supply to retina or visual cortex give 2 causes of amaurosis fugal? TIA temporal arteritis what is the commonest cause of visual loss in elderly? ARMD give 2 causes of acute optic neuropathy? MS atherosclerosis - ischaemia in acute optic neuropathy, describe the visual loss rapidly progressive decreased colour visa spontaneous appearance of blood between sclera and conjunctiva. diagnosis? and causes subconjunctival haemorrhage trauma, rubbing, severe coughing HTN, clotting disorder mild eye irritation and redness, SUPERFICIAL. diagnosis? what is this assoc. with? episcleritis collagen vascular disorders - RA 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 history of pain, FB sensation, blurred vision, photophobia. diagnosis? and where would redness be? corneal ulcer max red around cornea 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 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 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 infection of eyeball after eye surgery, blurred vision painful eye, photophobia, floaters. diagnosis? Rx endophthalmitis Rx: inject abx, surgical vitrectomy what are the features of grade I hypertensive retinopathy? tortuous arteries, thick shiny walls (silver wiring) 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) if there is redness most marked around cornea, what is this diagnosis? anterior uveitis if there is a red eye and dilated pupil, diagnosis? acute glaucoma if there is a red eye and small pupil, diagnosis? anterior uveitis what are the features of background DR? HEM haemorrhages - blots exudates (hard) - lipid deposits microaneurysm - dots what are features of pre-proliferative DR? microaneurysm haemorrhages exudates cotton wool spots venous beading (all signs of retinal ischaemia) REFER TO SPECIALIST 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 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 what is the Rx of cataract? remove when interfere with ADL put intraocular lens in 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 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