Sudden Vision Loss
Primary Care CME on Sudden Vision Loss.
A broad view and summary of a scary, sudden and seemingly complex disorder.
Eligible for FibonacciCME Credit
Members: Log into APP for Online CME Test
Continuing Medical Education
To recognize the possible causes of sudden vision loss
To determine the initial diagnostic evaluation of sudden vision loss
To determine when to refer sudden vision loss urgently to the appropriate specialist(s) for treatment
An Approach to Acute Vision Loss CME
by Eleni Florakis and George J. Florakis, MD
Acute vision loss can be very distressing to both patients and physicians and extremely important to diagnose in a timely manner. There are many different causes of acute vision loss which can occur anywhere along the visual tract, from the cornea to the occipital lobe . Acute vision loss may be benign and reversible, but it may also represent a more malignant, irreversible process. Prompt diagnosis is necessary to treat and potentially save the patient’s vision and/or life.
As with any new presenting symptom, the first step is to obtain a thorough history and physical. Acute vision loss can be caused by many different etiologies including ocular, vascular, and neurological pathologies. A detailed medical history may help determine whether one of these categories of pathology should be considered.
The Conclusion to An Approach to Acute Vision Loss which covers the following topics:
Hints from the Past Medical History Consider:
Primary ocular pathology
Vascular etiology (retinal artery or vein occlusion, cardiac emboli, carotid occlusive disease or vertebrobasilar disease)
Hyperviscosity syndrome and vascular etiology
Hints from the History of Present Illness
Dimming of the vision
Reduction in the visual field
Showering of black dots
Floating, moving scotoma
Sudden vision loss that only lasts a few seconds
Binocular vision loss
Flashes of lights or floating shadows
Ocular pain with eye movement
Localized ocular pain
Painful visual impairment
Hints from the Physical Exam
Injection or chemosis
Relative afferent pupillary defect (RAPD)
Topical fluorescein application
Color vision testing
Abnormal red reflex exam
retinal hemorrhaging and/or retinal whitening
optic disc pallor
increase in the cup-to-disc ratio
macula cherry-red spot
deficits of the optic nerve, oculomotor nerve, trochlear nerve, and the ophthalmic branch of the trigeminal and abducens nerves
deficits in the maxillary branches of the trigeminal nerve along with central retinal vein occlusion
Two Diseases You Shouldn’t Forget
Giant cell arteritis
History of Present Illness
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ABOUT THE AUTHORS
Eleni Florakis is currently a fourth-year medical student at the Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia, PA. She is interested in pursuing a residency in Internal Medicine and possibly practicing as a Primary Care Physician or Gastroenterologist in the future. She enjoys volleyball, and she continues to play flute for her medical school orchestra.
George J. Florakis, M.D.
George J. Florakis, M.D. is currently a Clinical Professor of Ophthalmology at the Columbia University Medical Center. Dr. Florakis attended medical school at Columbia’s College of Physicians and Surgeons. He completed his residency training at the Edward S. Harkness Eye Institute at the Columbia Presbyterian Medical Center. His fellowship in Corneal and External Eye Diseases was conducted with Dr. Jay Krachmer at the University of Iowa.
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