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Gradual visual loss Sudden onset visual loss

Cataracts Migraine

Macular degeneration Amarousis fugax (TIA)

GlaucomaAcute onset closed angle glaucomaPresbyopia Vitreous haemmorrhage

Retinal vein thrombosis

CATARACT:

-lens opacity, therefore causes (gradual) BLURRY VISION

-Glare and dazzle from headlights at night

-Treatment: surgery (for driving 6/12 or better in one eye is required). Usually

performed under LA and a micro-incision of an intraocular lens implant.

GLAUCOMA-chronic or chronic open angle glaucoma.

-optic neuropathy

-causes PERIPHERAL LOSS OF VISION WITH CENTRAL SPARING (so patient

can have normal visual acuity)

-raised IOP causes ischaemic atrophy of the optic nerve, which leads to atrophic

cupping of the disc, therefore increased cup:disc ratio

-frequently(but not always) associated with raised intraocular pressure

-Risk factors:

age, family history, diabetes, thyroid eye disease, myopia

NB: the optic nerve is cut into tenths and the cup: disc ratio is calculated.

In glaucoma you get an increased cup: disc ratio.

Diagnosis: application tonometry, which is the pressure needed to flatten the

corneal surface with a probe.

-Treatment: reducing IOP (even in patients with visual field changes of

glaucoma but normal IOP, called normotensive glaucoma).

Give prostaglandin analogues (e.g. latonoprost) and beta blockers(e.g.

timolol). Or oral acetazolamide (carbonic anhydrase inhibitor).

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MACULAR DEGENERATION