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    Presentation 2

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    Tasissa Ayela
    The document lists various potential causes of gradual vision loss, including refractive errors, cataracts, age-related macular degeneration, glaucoma, inherited eye conditions, and systemic or toxic issues. It emphasizes that determining the laterality, time course, and associated symptoms can help identify the etiology. For example, sudden unilateral vision loss may indicate an ischemic event while gradual bilateral loss over months to years could be from compressive lesions or toxic neuropathies. A thorough medical, ocular, and medication history is also important for the evaluation.

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    Presentation 2

    Uploaded by

    Tasissa Ayela
    22 views10 pages
    The document lists various potential causes of gradual vision loss, including refractive errors, cataracts, age-related macular degeneration, glaucoma, inherited eye conditions, and systemic or toxic issues. It emphasizes that determining the laterality, time course, and associated symptoms can help identify the etiology. For example, sudden unilateral vision loss may indicate an ischemic event while gradual bilateral loss over months to years could be from compressive lesions or toxic neuropathies. A thorough medical, ocular, and medication history is also important for the evaluation.

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    The document lists various potential causes of gradual vision loss, including refractive errors, cataracts, age-related macular degeneration, glaucoma, inherited eye conditions, and systemic or toxic issues. It emphasizes that determining the laterality, time course, and associated symptoms can help identify the etiology. For example, sudden unilateral vision loss may indicate an ischemic event while gradual bilateral loss over months to years could be from compressive lesions or toxic neuropathies. A thorough medical, ocular, and medication history is also important for the evaluation.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    22 views10 pages

    Presentation 2

    Uploaded by

    Tasissa Ayela
    The document lists various potential causes of gradual vision loss, including refractive errors, cataracts, age-related macular degeneration, glaucoma, inherited eye conditions, and systemic or toxic issues. It emphasizes that determining the laterality, time course, and associated symptoms can help identify the etiology. For example, sudden unilateral vision loss may indicate an ischemic event while gradual bilateral loss over months to years could be from compressive lesions or toxic neuropathies. A thorough medical, ocular, and medication history is also important for the evaluation.

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    Write systemic or ocular causes gradual loss of vision

    Causes can be but are not limited to…


    Refractive error, including keratoconus, myopic degeneration, presbyopia

    Cataract, Posterior capsular opacification (PCO) (post-cataract surgery).

    Age-related macular degeneration.

    Primary open angle glaucoma (although ‘presentation’ with visual loss is unusual).

    Inherited maculopathies and keratopathies

    Toxic, drug-related.

    Neuro-ophthalmic problems

    Systemic illnesses (more discussed in your seminar)


    History

    In cases of decreased vision, 3 aspects of pt’s Hx—in addition to


    age—are crucial in determining the etiology:

    1. Laterality= unilateral/bilateral

    2. Time course= sudden onset/ progressive

    3. Sxs associated
    Time Course of Vision Loss

    • Sudden onset- an ischemic event

    • Over days to wks- inflammation

    • Gradual progression over months/yrs- compressive lesions, toxic or


    nutritional optic neuropathies (may present more acutely), glaucoma

    • Sudden loss of vision Vs. sudden awareness of VL

    • Time courses of various etiologies overlap considerably


    Associated Symptoms

    • Ipsilateral periorbital pain that increases w eye mov’t.. optic neuritis

    • Associated neurologic Sx.. demyelinating disease

    • Nonspecific pain, facial numbness, or diplopia .. orbital or cavernous


    sinus lesion

    • Headache, jaw claudication, and systemic Sx.. giant cell arteritis (GCA)
    Other Ocular symptoms

    • Night blindness (nyctalopia)

    Vit A def, retinitis pigmentosa (RP), after laser therapy for Diabetic retinopathy

    • Peripheral visual loss (‘bumping by shoulders into

    Glaucoma, RP, bitemporal hemianopia due to ?, after laser therapy for DR

    • Central (dark) scotoma, Visual distortion (metamorphopsia)

    Age-related macular degeneration, inherited maculopathies


    Other Ocular symptoms
    Glare Redness, photophobia, pain

    Cataract, corneal scars Uveitis, Infections

    Floaters Pain on movement of eyes

    Vitritis, retinal detachment Optic neuritis


    Past Ocular History

    • Spectacle/Contact lens use

    • Eye drops

    • Surgeries

    • Poor vision a few months to yrs after cataract surgery, ask if it feels like
    cataract has grown back>>> PCO

    • Laser treatments

    • Trauma
    Medical History

    • Stroke, Embolic retinal • Asthma


    vascular occlusions • Diabetes
    • Transient and or recurrent VL, • Hypertension
    e.g amaurosis fugax
    • Epilepsy

    • Immuno-suppresion
    Medications History

    • Antihypertensive, antidiabetic • Tamoxifen


    meds
    • Alcohol, tobacco
    • Anti TB meds, HAART

    • Steroids

    • Antiepileptics

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