visual symptomology from optometrist point of view
DESCRIPTION
Eye ComplaintsTRANSCRIPT
PREPARED BY:
ANIS SUZANNA BINTI MOHAMAD A123369
CHONG TENG CHOU A122615 SIAH SOO KIONG A122506 OOI TING SHAN
A122573 PATRICIA LOWA122679 NUR SYUHADA
BT ALWI A123526
Visual symptomology
Visual symptoms
1. Blurred Vision2. Double vision3. Vision loss4. Photopsia5. Hallucination6. Floater7. Colored halos around
eye8. Photophobia9. Dazzling or glare
discomfort10. Chromatopsia
11. Heightened color perception
12. Nyctalopia(night blindeness)
13. Hemeralopia (day blindness)
14. Oscillopsia15. Color blindness16. Palinopsia17. Visual agnosia18. Ocular lateropulsion19. Pain in and about eye20. Headache
1.Blurred vision
Loss of visual acuity with indistinct detail.
Can be unilateral or bilateral.Can be blur at near, blur at distance
or bothMagnitude of a patient’s complaint
will depend on many factors including- the degree of defect- type of visual task being undertaken
May result from eye injury, refractive error, eye disease, improperly fitted contact lens or use of certain drug. Normal
Vision with diabetic
retinopathy
History taking part
How long he has had the visual blurring.Does it occur only at certain times? Ask about associated signs and symptoms, such as
pain or discharge. If visual blurring followed injury, obtain details of
the accidentAsk if vision was impaired immediately after the
injury. Obtain a medical and drug history.
Etiology
Medical causes Brain tumor Cataract Concussion Corneal abrasion Conjunctivitis Corneal dystrophies Corneal foreign bodies Diabetic retinopathy Dislocated lens Eye tumour Glaucoma
Hypertension Hyphema Iritis Migraine headache Multiple sclerosis (MS) Optic neuritis Retinal detachment Retinal vein occlusion
(central) Senile macular degeneration Serous retinopathy (central) Stroke Temporal arteritis Uveitis (posterior) Vitreous hemorrhage
2.Double vision
DiplopiaMostly seen in
binocular anomalyCan be unilateral or
bilateralGeneral cause is from
cornea, crystalline lens, muscle, nerve and brain.
Double vision is not normal and should be reported promptly.
Etiology
CorneaInfections of the
cornea(herpes zoster or shingles)
Uncommon complication of LASIK surgery.
Crystalline lenCataract MuscleMyasthenia gravis Graves’ disease
Nerve Multiple sclerosisGuillain-Barre
syndromeUncontrolled diabetes BrainStrokesAneurymsBrain tumourIncreased pressure
inside the brain from trauma, bleeding or infection
3.Vision loss
Inability to perceive visual stimuli
Can be sudden or gradual and transient or permanent
Range from slight impairment to total blindness
Age-related Macular
degeneration
Normal Vision
Glaucoma
Hemiapnosia
Etiology of sudden vision loss
always a medical emergency
Eye injury Eye artery obstruction -
this cause and other causes are a medical emergency.
Retinal artery obstruction
Retinal vein obstruction Eye blood vessel
thrombosis Temporal arteritis Retinal detachment
Amaurosis fugax Stroke TIA (Transient
ischemic attack)Migraine Optic neuritis Vitreous hemorrhage Acute glaucoma Methyl alcohol
poisoning Hysteria Brain injury Blow to the head
Etiology of gradual vision loss
Cataract Macular degeneration Age-related macular
degeneration Diabetic retinopathy Glaucoma Hypertension Choroiditis Retinitis pigmentosa Trachoma
Field of Vision Loss in Late Retinitis Pigmentosa
Loss of vision associated with
macular degeneration
4.Photopsia
Hallucinatory perceptions such as sparks, lights or colours arising in the absence of light stimuli and observed when the eyes are closed.
Etiology:posterior vitreous
detachmentmigraine with aura migraine aura
without headacheretinal break or
detachmentoccipital lobe
infarction sensory deprivation
5.Hallucination
Definition: Visual perception not
evoked by a light stimulus.
Perceptions in a conscious and awake state in the absence of external stimuli which have qualities of real perception, in that they are vivid, substantial, and located in external objective space
Etiology
Blind person (central or peripheral visual field loss)
Bilateral eye covering (after surgery)Ocular lesions as retinal haemorrhage,
glaucoma, optic atrophyPsychosesCentral nervous system lesion (Alzheimer
disease)
6.Floaters
Floaters are little "cobwebs" or specks that float about in the field of vision.
Dots or filaments that move with the movement of eye
Etiology: Vitreous opacities Scotomatous defects
(retinal lesion, myopia)
Corneal foreign body reflection
Carbon tetrachloride poisoning
Migraine
7.Colored halos around lights
Blue and violet are next to the stimulating light and red outermost.
Etiology: Glaucoma-A.acute-angle closure with
streching of the corneal lamellae
B.open-angle glaucoma-halo noted in the awakening (IOP highest in morning)
Mucus on the cornea Corneal scar/ edema Krunkenberg spindle Lens opacities Vitreous opacities Haze of ocular media
8.Photophobia
Defination: Painful intolerance of
the eyes to light. symptom of a primary
ocular disorder or underlying central nervous system disorder
Etiology Aniridia ocular
(conjuctivitis,keratitis, iritis)
Albinism Total color
blindness(achromaptosia)
Systemic disease Toxic cause Drug induced
(digitoxin)
9.Dazzling or glare discomfort
Definition: difficulty seeing in the presence of
bright light such as direct or reflected sunlight or artificial light such as car headlamps at night.
Patient with glare discomfort
Normal patient without glare discomfort
Etiology
1. Altered pupillary response
2. Asymmetric placement of the IOL in relation to the pupillary aperture
3. Corneal scars or foreign bodies
4. Idiopathic
5. Drugs such as chloroquine,acetazolamide, or trimethadione (Tridone)
6. Emotional disorders7. Following refractive
surgery8. Lenticular changes
Definition: Definition: Etiology:Etiology:
Abnormal condition in which objects appear falsely coloured.
It named depending upon the colour seen.
1. Cone monochromatism• Blue cone
monochromatism - abnormal vision of blue color
2. Drugs 3. Genetic 4. Macular degeneration 5. Optic neuritis 6. Retinitis pigmentosa
10.Chromatopsia
Classification of chromatopsia
11.Heightened Color Perception
1. Heightened color perception is due to drugs, including the following:
dronabinolethionamidehashishLSDlysergidemarihuanamescalineoxygenpsilocybintetrahydrocannabinolTHC
Sources from: Fraunfelder FT, Fraunfelder FW. Drug-induced
ocular side effects. Woburn, MA: Butterworth-Heinemann, 2001.
Usually happened in person with dementia
12.Nyctalopia (Night Blindness)
Definition: a condition making it
difficult or impossible to see in relatively low light.
It is a symptom of several eye diseases
Difficulty sees in darkness
Etiology
Vitamin A deficiencyretinitis pigmentosacongenital night
blindnessSorsby's fundus
dystrophypathological myopiaperipheral cortical
cataractOguchi diseaserefractive surgery
(RK, PRK, LASIK)
13.HemeralopiaDefinition: Day blindness
inability to see as distinctly in a bright light as in dim one
It can be described as insufficient adaptation to bright light.
The retinas of those with day blindness are unable to process the light around them.
This, in turn, intensifies the sunlight so much that they literally can't see anything around them.
Etiology
1. Adie’s pupil2. Albanism3. Aniridia4. Cohen Syndrome5. Cone dystrophy-
genetic condition6. Drugs:- Trimethadone7. Cataracts8. Trauma:- Brain injury
Ocular complications are listed as optic atrophy ,microphthalmia ,pigmentary chorioretinitis , hemeralopia (decreased vision in bright light) , myopia , strabismus , nystagmus and iris/retinal coloboma.
14.Oscillopsia
Defination: A visual disturbance
in which objects in the visual field appear to oscillate.
The severity of the effect may range from a mild blurring to rapid and periodic jumping.
Etiology :Etiology :
loss of the vestibulo-ocular reflex
involuntary eye movements such as nystagmus
impaired coordination in the visual cortex (especially due to toxins) aminoglycoside
Illusionary movement of enviroment
unilateralbilatarel
15.Color blindness
Definition: A.k.a color
vision deficiency
the inability to perceive differences between some of the colors that others can distinguish.
Color blindness Deficiency in color vision can be due to:
Inherited defects
- present from birth and have genetic basis
- affect both eyes equally
- affect the entire visual field
Acquired defects
-secondary to a pathological state
-may affect one eye -may affect part of
the visual field
Classification of color blindness
Ocular diseases which causes color vision disturbances
Ocular diseases Color vision changes
Age-related maculopathy Blue-yellow defect
Retinal detachment Blue-yellow defect
Diabetic retinopathy Blue-yellow defect
Hypertensive retinopathy Blue-yellow defect
Papilledema Blue-yellow defect
Glaucoma Blue-yellow defect
Lesions of optic nerve &pathway Red-green defect
Papillitis Red-green defect
Optic neuritis Red-green defect
16. Palinopsia
Visual disturbance that causes images to persist to some extent even after their corresponding stimulus has left
These images are known as afterimages and occur in persons with normal vision.
A person with palinopsia experiences them to a significantly greater degree, to the point where they become difficult or impossible to ignore
Palinopsia : Symptoms
Causes
lesion parieto-occipital temporal-occipital areas as a result of a cerebral
infarction, epilepsy, tumour, or brain injury
17.Visual agnosia
Visual agnosia is a neurological disorder distinguished by the inability to recognize familiar objects.
Types :
1)Appreceptive Agnosia2)associative visual agnosia
Appreceptive Agnosia - Failure in high-level object recognition despite normal vision
Symptoms : Pt are unable to recognize objects Unable to access the structure or spatial properties of
a visual stimuli Object is not seen as a whole. Cannot draw or copy things
Causes : damage in the lateral occipital area
Drawing Test Result
Associative visual agnosia
inability to identify objects due to impaired access to stored semantic information about the objects.
Causes : lesion on the left occipital and temporal
lobe, often in conjunction with damage to the posterior thalamus and limbic cortex.
Criteria :
Difficulty recognizing variety of visually presented objects with their semantic meaning, or organize objects into semantic categories.
Normal recognition of objects from a verbal description of it or when using sense other than vision (e.g. smell, touch, taste).
Elementary visual perception that is sufficient to copy line drawings quite well but unable to identify objects being copied
• copy line drawings quite well • unable to identify objects being copied
18.Ocular Lateropulsion
A strong forced conjugate deviation of the eyes to one side.
a position bias of eye movements in the direction towards the lesion
Symptoms : Unable to reach a laterally placed fixation target in a
single rapid eye movement (a single saccade) Patients overshoot towards the side of the lesion and
undershoot in opposite direction.
Cause : Asymmetrical lesion of the pons and lateral medullar
19.Pain In and About Eye
Symptoms burning, throbbing, aching, or stabbing sensation in or around
the eye. feel as if there is a foreign body in the eye.
Causes
Burns Conjunctivitis (pink eye) or any inflammation of the upper and
lower lids Contact lens complications Eye problems (infection, irritation, or injury such as a corneal
abrasion) Eye surgery Glaucoma Migraine headache Sinus problems Stye (hordeolum) Viral infections such as the flu
20.Headache
Headaches often appear centered around the eyes or behind the
eyes.
Symptoms : referred area of the pain is
around the eyes. a brow ache or an ache behind
the eyes.
Causes :
• Eyestrain - overworking of the focusing muscle within the eye.
• Contact lens related problems - headache may come from a poorly fitting, tight lens, corneal infection or swelling, or from a lack of oxygen in the cornea.
• Corneal ulcer • Conjunctivitis • Dacryocystitis - an infected tear drainage sac
(inside corner of the eye) can lead to pain and headache
• Glaucoma (acute) • Optic neuritis - inflammation of the optic nerve can
cause headache and pain on eye movement along with blurred vision
-THE END-