2022 Sudden Loss of Vision 2 Optom UG PDF

NON EMERGENCY SUDDEN VISION LOSS SUDDEN LOSS OF VISION 2 URGENT N...

NON EMERGENCY SUDDEN VISION LOSS SUDDEN LOSS OF VISION 2 URGENT NEVERTHELESS Elias Hussein Urgent Care or Emergency Care URGENT BUT NON EMERGENCY ME How is it different? Central / Branch Retinal Vein Occlusion N B ECO GENCY Vitreous Haemorrhage in Diabetics CA -EMER I SEM Optic Neuritis ARMD CSCR Retinal Detachment – Semi-Emergency Cerebral Causes* – Eg Brain tumours * Exception – Stroke is an EMERGENCY SUDDEN LOSS OF VISION Central / branch retinal vein occlusion Vision may be normal or markedly decreased NO REDNESS Depends to a large extent on Macular LOOKS “NORMAL” involvement Usually unilateral I JUST CANNOT SEE! Retinal haemorrhages Cotton wool spots Macular Oedema  Central / branch retinal vein occlusion Vitreous hemorrhage – Proliferative DR Bomb Cluster Bomb Vitreous hemorrhage – Proliferative DR Vitreous hemorrhage – Proliferative DR Sudden visual loss in a diabetic patient Too late to treat with laser when this happens DETECTION before bleed is critical  cataract Neovascular ↑ glaucoma (NVG) is explained as a severe secondary glaucoma condition that is characterized by fibrovascular tissue proliferation in the anterior chamber angle. -Serrabung ne baurah NEOVASCULAR GLAUCOMA – Clinical Features SECONDARY ACUTE GLAUCOMA 1. Red eye 5. High IOP 2. Hard eyeball 6. Pupil – not reactive to 3. Hazy Cornea light, mid dilated Onset – progressive, sub-acute 7. Vessels on the iris 4. Shallow AC 8. May see a hyphaema 1. Eye pain, headache 2. Eye redness 3. Nausea/vomiting 4. Blurring of vision  Questions??? Back to the Normal looking Eye SUDDEN LOSS OF VISION Optic neuritis ↓ Ot Progressive Acute loss of vision optic nerve Central Scotoma NO REDNESS Positive RAPD Fundus: swollen disc, LOOKS “NORMAL” haemorrhages, hyperemic I JUST CANNOT SEE! If left untreated will always result in complete irreversible - blindness reversible until it fines occurs many Optic neuritis pudar Age related macular degeneration What is ARMD? Vitreous hemorrhage AMSLER GRID – A POWERFUL TOOL Central serous chorio-retinopathy (CSCR) pimple macular · in drea stress · a collection of fluid under the retina. (bubble) disturbance in the pumping action of RPE cells (retinal pigment epithelial cells) and/or abnormalities in the vascular (blood vessel) layer, known as choroid. fluid leakage under the retina in a bubble-like swelling SYMPTOMS - CSCR CSCR usually affects those between 30 to 50 years of age. Males are more likely to be affected then females. Main painless blurriness of central vision. distortion or a change in size of an object. straight objects or lines seeming curved (distorted). difficulty in reading small prints with the affected eye. some patients notice that they need to change reading glasses more often. In most cases, the symptoms only last for a few months; however it may last longer in a minority of patients, potentially leading to a long-term SEMI -  · predisposed Retinal Detachment Cada j emergency refina detachment aday X emergency ( fact Floaters / Flashes t Peripheral VF loss high salach Loss of central vision > 3 - myope Pale red reflex Cuadran + ] ↑ power Can see detached retina thinner retina Retinal Detachment progressive ↑ Retinal Detachment – Emergency vs Urgent Loss of Vision due to Cerebral causes critical > - macula not enough damage > pooron tauk blood X supply - Sudden, Severe and complete visual loss – usually both eyes f Field loss (eg pituitary) bitemporal / homonymous hemianopia Unique – pupillary reaction will always be abnormal - normal More ugent localised  a blood < cukup mascn blood vessel peal dim stab otak Visual Field Loss  Summary CRAO – an especially time sensitive emergency AION – the other eye CAN be saved Retinal Detachment – SOMETIMES! STROKE or CVA is an EMERGENCY RAPD a very important sign to assess status of OPTIC NERVE Visualization of the fundus/optic disc critical burang - > cuba blood overcome supply SUDDEN LOSS OF VISION ↓ Stimulate) The End VGEF > [vascular] - NO REDNESS LOOKS “NORMAL” I JUST CANNOT SEE! Up coming lectures: Homework - XXX Gradual Loss of Vision – 1 & 2 ANY QUESTIONS? Age Related Cataract Chronic Open Angle Glaucoma Ask a question about something you do not understand Corneal Dystrophies about Sudden Loss of Vision by 2359hrs (1159pm) on 28.04.2022 Keratoconus Send question to [email protected] with your NAME stated before the question eg “ Question by XYZ is.......... “