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Vascular disorders
Retinal Artery Occlusion
Causes & Predisposing Factors
- Clot
- Sclerosis
- HTN
- DM
- Atrial Fibrillation
- Temporal arteritis
Clinical Presentation
- ACUTE vision loss
- Partial
- Complete
- NO PAIN
Labs, Studies and Physical Exam Findings
- Fundal exam
- Optic atrophy
- Pale disc
- Cherry red spot – its actually that the rest of the retina is pale
- Boxcarring- narrowing of arterioles
Treatment
- EMERGENCY
- Referral
- Intermittent pressure
- tPA
Central Vein Occlusion
Causes/Predisposing Factors
- HTN
- DM
- Sickle Cell
- Glaucoma
Clinical Presentation
- Vision loss
- Blurred Vision
Labs, Studies and Physical Exam Findings
- Fundal exam
- Blood and thunder fundus
- Neovascularization
- Dilated veins
- Exudates
Treatment
- Treat underlying cause
- Usually will resolve to some degree
Vision Abnormalities
Amaurosis Fugax
- Think TIA of the eyeball
Causes/Predisposing factors
- Carotid plaques
- Atrial fibrillation
Clinical Presentation
- Transient ACUTE vision loss
- Curtain descends and then goes back up
- Unilateral
Treatment
- Treat underlying cause
- Heparin
Strabismus (Cross Eyed)
Hypotropia – one eye goes down
Hypertropia – one eye goes up
Exotropia – one eye out
Esotropia – one eye goes in
Clinical Presentation
- Cross eyed
- Double vision
- Headaches
Labs, Studies and Physical Exam Findings
- Cover/uncover test
- Hirschberg corneal reflex test – Shine a flashlight in a patient’s eye. The light reflection should be in the same place on each eye.
Treatment
- Children – the goal is to avoid amblyopia (see below)
- Glasses
- Eye patch
- Surgery
- Adults
- Glasses
- Surgery
Amblyopia (Lazy -eye)
- A loss of vision in an otherwise normal eye secondary to the neural pathway not functioning properly.
- Most often this is secondary to a strabismus.
- Vision is not corrected with glasses
Treatment
- Treatments are most successful at an early age
- Treatment is forced use of the weaker eye
- Eyepatch
- Glasses
- Drops to blur vision in the stronger eye