Acute visual loss

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Acute visual loss

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Acute visual loss

  1. 1. Acute visual dysfunction Sendhil Kumar Senior registrar Ophthalmology Department SCGH
  2. 2. Definition Loss of vision over few minutes to days Unilateral or Bilateral Part or full visual field
  3. 3. Patho-physiology Optical media Retinal layer Optic nerve dysfunction
  4. 4. absent present RAPD + Optic nerve dysfunction/ gross retinal pathology - Macular/ limited retina Anterior or posterior segment media issues
  5. 5. Relevant history Pain +/Trauma Central/Peripheral Flashes/Floaters Co-morbids Medication
  6. 6. Examination • • • • • • General Status Vision RAPD Slit-Lamp IOP Funduscopy
  7. 7. Painless…
  8. 8. Retinal vein occlusion
  9. 9. Central retinal artery occlusion
  10. 10. Retinal detachment
  11. 11. Advance Diabetic Eye Disease
  12. 12. Central Serous Chorioretinopathy
  13. 13. Papiledema
  14. 14. Subretinal bleed
  15. 15. Ischemic optic neuropathy
  16. 16. Painful…
  17. 17. Acute congestive glaucoma
  18. 18. Signs of keratitis
  19. 19. Keratitis
  20. 20. Trauma Hyphaema Sphincter tear Cataract Lens subluxation Iridodialysis Angle recession Vossius ring Rupture of globe
  21. 21. Commotio retinae Choroidal rupture and haemorrhage Avulsion of vitreous base and retinal dialysis Equatorial tears Macular hole Optic neuropathy
  22. 22. Flat anterior chamber Uveal prolapse Vitreous haemorrhage Tractional retinal detachment Damage to lens and iris Endophthalmitis
  23. 23. Grading of severity of chemical injuries Grade I (excellent prognosis) • • Grade III (guarded prognosis) Grade IV (very poor prognosis) • No iris details • Opaque cornea • Limbal ischaemia - 1/3 to 1/2 • Limbal ischaemia > 1/2 rade II (good prognosis) Cornea hazy but visible iris details Limbal ischaemia < 1/3 Clear cornea Limbal ischaemia - nil
  24. 24. Optic Neuritis Retrobulbar neuritis (normal disc) Papillitis (hyperaemia and oedema) • Neuroretinitis (papillitis and macular star) • • • • •
  25. 25. Slit-lamp

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