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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?
what is the commonest cause of visual loss in elderly?
give 2 causes of acute optic neuropathy?
- 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?
- 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?
- 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
- 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?
if there is a red eye and dilated pupil, diagnosis?
if there is a red eye and small pupil, diagnosis?
what are the features of background DR?
- haemorrhages - blots
- exudates (hard) - lipid deposits
- microaneurysm - dots
what are features of pre-proliferative DR?
- cotton wool spots
- venous beading
- (all signs of retinal ischaemia)
- REFER TO SPECIALIST
what are features of proliferative DR?
- new vessels - disc or elsewhere
- URGENT referral
in DR, when is it necessary to refer to ophthalmologist? (4)
- background with macular changes
- background with decreased vision
what happens to the lens in cataract?
loss of transparency of crystalline lens
what are the causes of cataract?
- SE of steroids
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