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