visualelderly - SURGICAL Trabeculectomy Laser AION...

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VISUAL LOSS IN THE ELDERLY
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Aetiology • Sudden – Retinal • Retinal vascular occlusion •W e t AMD – Neurological •A ION • Neurological visual field loss
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Cataract
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Cataract • Slow, painless decrease of vision •G l
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Types of Cataract
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Management Interfering with daily activities Cause of other ocular diseases –g l a u c om a – uveitis
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7
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Aqueous Outflow
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Glaucoma • Primary open angle – Reduced outflow and poor optic nerve perfusion • Secondary open angle – Ocular disease • Ocular inflammation •T r a um a
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Symptoms • Often none until extensive loss of V F • ‘Bumping into things’ • Gradual deterioration of near vision • Pain very uncommon unless IOP very high
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Treatment MEDICAL ß-Blockers(side effects!) PG agonist α 2 adrenergic agonist Parasympathomimetics •C A I
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Unformatted text preview: SURGICAL Trabeculectomy Laser AION Arteritic Older patients Second eye involved 75% Polymyalgia Rheumatica Non-arteritic Younger HT, DM Arteritic IAON Headache, scalp tenderness Thickened temporal artery Jaw claudication Weight loss, anorexia, fever, night sweats, malaise, depression Raised ESR CRAO, CN palsy Retinal Vein Occlusion Sudden, painless VF defect loss of vision Retinal Artery Occlusion Sudden, painless VF defect loss of vision Amaurosis fugax CVA, TIA Cherry spot Investigations for retinal vascular disease Visual acuity, pupil reflexes, visual field BP, pulse, ECG BSL, FBC, U/Es Protein electrophoresis Carotid doppler Macular Disease Commonest cause of untreatable visual loss in the elderly Distortion Deterioration of central visual acuity Normal pupil reflexes Dry AMD Drusen Exudative AMD...
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visualelderly - SURGICAL Trabeculectomy Laser AION...

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