Elderly Eyes
BGS Trainees’ Weekend
Dry AMD
• Gradual central blurring of vision
• Drusen• Pigment changes• Vitamin supplements
Wet AMD• Sudden central
blurring of vision• Distortion • Haemorrhage• Anti-VEGF injections
Vision is visual acuity AND visual fields
• Visual pathway – anatomy from retina to occipital lobe
• Can have normal VA but poor VF
• Vertical midline defects – neurological
• Visual fields to confrontation
Pupil reactions
• Inspect for unequal pupils– Efferent (motor) problem
• Perform swinging torch test– Afferent (sensory) problem– Relative afferent pupillary defect (RAPD)
• Need to know the anatomy of the pupil light reflex
Optic disc swelling
• Direct ophthalmoscopy
• Bilateral– Raised intracranial pressure (papillodema)– Accelerated hypertension
• Unilateral– Anterior ischaemic optic neuropathy
Temporal arteritis
• Over 55
• Sudden loss of vision
• RAPD
• Disc swelling
• Complete blindness can occur if undiagnosed or undertreated
Diabetic eye disease
Leakage Blockage
Sudden loss of vision in elderly
• Wet AMD
• Retinal vascular occlusion
• Amaurosis fugax
• Anterior ischaemic optic neuropathy
• Acute glaucoma
• Occipital stroke
Gradual loss of vision in elderly
• Cataract
• Dry AMD
• Diabetic exudative maculopathy
Powerpoint presentation
• Talk on slideshare
• Access via The Eye Expert website
• www.theeyeexpert.co.uk
• Under News section