Visual Acuity Decrease

 

1- occlusion of the central artery: In the retina

* Visual acuity collapsed abruptly limited to light perception

* The pupil is mydriasis aréflectique. Abolition of direct RPM RPM with preservation of consensus in the illumination of the healthy eye.

* It is most often due to embolic disease

* The fluorescein angiography is not essential

* The final retinal lesions appear after 90 min of ischemia

At the back of the eye:

* Diffuse narrowing of the arterial caliber and sometimes grainy current

* A few hours later -> ischemic retinal edema “milky white” contrasting with a “cherry red spot in the macula.”

Diagram of the retina

Diagram of the retina

2- central vein occlusion: From the retina

* Acute onset of blurred vision (varies according to clinical form)

* The edema is the most common form (¾); but the passage to ischemic form is possible.

At the back of the eye: The cardinal signs are

* The papilledema

* Bleeding sprinkled all over the retinal surface: Surface (splinter) or deep (sclerosis).

* The cotton wool spots (signs of ischemia) rare in the edematous form

* Venous changes: tortuosity and venous dilatation

3- AMD: Macular degeneration

* Starts after 50 years; reached selectively macula

* FDR: age;

smoking;

HTA; light color of the iris; significant exposure to light; genetic factors.

* Clinic: metamorphopsia (deformation of object); central scotoma; there is a decrease in the early phase of the near visual acuity.

* In FO: drusen; hemorrhage and / or detachment of the retina macular …

4- Retinal detachment:

* Rhegmatogenous detachment (secondary to retinal tear)

* It recognizes three main causes: idiopathic (elderly); high myopia; cataract surgery.

* SF: myodésopsies (floaters) followed phosphenes and amputation of the peripheral visual field (black veil)

* FO: Relief retina, mobile phone, cerebriform appearance

NOIA: anterior ischemic optic neuropathy

* Decline in brutal unilateral visual acuity, usually massive

* Decreased pupillary reflex live

* Total papillary edema or sector

* Fascicular deficit (or central scotoma) in the examination of the visual field

* The most common cause is atherosclerosis. Systematically GCA;

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