Shared Flashcard Set

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Vision Loss and Diplopia
...
24
Medical
Graduate
08/10/2011

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Cards

Term
CP of Giant Cell Arteritis
Definition

Headache, temproal tenderness, jaw claudication, fevers, malaise, shoulder and girdle arthritis (polymyalgia rheumatica), transient blackouts in vision

white/chalky and swollen disc seen with fundoscopy, APD

Term
Explain afferent pupillary defect
Definition

tested by shining a bright and focused light from one eye to the other.  The initial response in each pupil should be constriction and both pupils should remain small.  If there is a left afferent pupillary defect then the both pupils will dilate when the light is directed at the left eye and both will constrict when the light is directed at the right eye.  It is NOT an indicator of visual acuity but indicates dysfunction at the level of the optic nerve or diffuse retinal dysfunction.

Term
CP of increased intracranial pressure vision loss
Definition
transient blackouts are positional
Term
Describe Amaurosis Fugax
Definition

·         monocular vision loss caused by a lack of adequate blood flow to the retina.  It is most often embolic, but can also be vasospastic, hypoperfusion, hyperviscosity of the blood, or unknown cause.

Term
Differential EP between Amaurosis Fugax and migraines
Definition

·         Patients with amaurosis fugax are typically older and have cardiac risk factors while patients with migraines are typically younger and often have a history of headache.

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Term
CP for retinal detachment
Definition

o   May have no symptoms, but classically are preceded by flashing lights, a rush of new small floaters, and a curtain/shadow/veil across a portion of the vision in one eye

Term
H of CRAO/CRVO
Definition

If there is every a young, healthy women with ANY diagosis that can be attributed to being hypercoagulable… don’t forget to ask about oral contraceptives and smoking.

Term
buzz words for CRAO
Definition
APD, cherry red spot
Term
Angle Closure precautions
Definition
DO NOT dilated unless there is a patent peripheral iridectomy (hole in the iris other than the pupil) to prevent exacerbation of the angle closure
Term
What anopsia does a middle cerebral artery lesion cause?
Definition
a contralateral homonymous superior quadrantanopsia or hemianopsia
Term
Describe the cells of the visual pathway
Definition
rods and cones (neuron 1), bipolar cells (neuron 2), ganglion cells (neuron 3, lateral geniculate nucleus, primary visual cortex (occipital lobe)
Term
prosopagnosia- definition and disease association
Definition

failure of facial recognition

Alzheimer's disease

Term
Where is a visual image inverted?
Definition
in the retina
Term
What is the underlying disease of central scatoma?
Definition
Multiple sclerosis
Term
Which tumor can cause bitemporal heteronymous hemianopsia?
Definition
craniopharyngioma
Term
describe subthalamic syndrome
Definition
hemiballism of the contralateral side
Term
CP of increased intracranial pressure
Definition
transient blackouts of vision that are classically positional (wrose with head down)
Term
what is the treatment if GCA is expected?
Definition
start high dose steroids due to risk of bilateral disease, then proceed with further work up
Term
Describe amaurosis fugax
Definition
a monocular vison loss caused by a lack of adequate blood flowto the retina. It is most often embolic, but can also be vasospastic, hypoperfusion, hyperviscosity of the blood or unknown cause.
Term
IF there is ever a young, healthy woman with any diagnosis that can be attributed to being hypercoaguable, such as acute vision loss...
Definition
ask about oral contraceptives and smoking, CRVO/ CRAO
Term
cherry red spot is a buzz word for
Definition
metabolic storage diseases- Tay Sachs, Hurlers, Niemann Pick's
Term
CP for CMV retinits
Definition
"ketchup and mustard" fundus due to hemorrhage alternating with focal ischemic areas
Term
Describe the pathogenesis, morphology and clinical features of Graves' Ophthalmopathy.
Definition
This is the leading cause of proptosis in adults. The proptosis is often asymmetric and can even appear to be unilateral. Orbital inflammation and engorgement of the extraocular muscles, particularly the medial rectus and the inferior rectus, account for the protrusion of the globe. Lid retraction is the most common and other symptoms include corneal exposure, lid retraction, conjunctival injection, restriction of gaze, diplopia, and visual loss from optic nerve compression.
Term
How is Grave's ophthalmopathy treated?
Definition
Acute Graves Ophthalmopathy is treated with topical lubricants as well as high dose oral/IV steroids. Radiation therapy is effective in some cases. Emergent orbital decompression may be required if there is compression of the optic nerve not responding to medical management and causing vision loss. Following the acute stage, topical lubricants are also used. If surgery is required, it is typically done “from the inside out” by starting with orbital decompression, followed by possible eye muscle surgery, followed by possible eyelid surgery.
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