Ocular intermittent angle closure glaucoma

940

arteritis.

involvement.

pale disc with

surface

the iris appear to touch.

seconds.

�

Visual function assessment: This should include- visual

�

hypotension.

transient visual loss may leave permanent visual loss

�

Anterior segment: Depth of anterior chamber for narrow

�

Eating chocolate as trigger factor for migraine

�

Look for causes of transient obstruction of the visual

Associated symptoms

�

Other neurological deficiets in thrombolic disease

�

Headache in papilloedema and giant cell arteritis

Acintra ocular lens.

�

embolism

Risk factors for cardiovascular disease- smoking, raised

�

Retina- for peripheral haemorrhages: midperipheral

punctate haemorrhage in pre retinal vein occlusion

Full ocular and cardiovascular examinations are

3. Hypoperfusion (hypotension, Hyperviscosity, hypercoagulability) 4. Ocular (intermittent angle closure glaucoma, hyphema, optic disc demyelinating optic neuropathy (multiple sclerosis). 7. Others - Psychogenic, Idiopathic

a. Thromboembolism b. Systemic hypotension

DOS Times - Vol. 11, No. 6

395

December, 2005

	Retinal oedema with
	Retinal oedema with		Central retinal vein occlusion (ischaemic) showing multiple
showing cotton wool spot haemorrhage from disc vessel	cilioretinal sparing: emboli at the first bifurcation of the
showing cotton wool spot haemorrhage from disc vessel		margins are blurred, the
in a patient with almost complete obstruction of both	temporal branch of the central retinal artery and more	vessels emerging from the disc are partly buried, and the
carotids.		capillaries on the nerve head
carotids.		are congested.


Branch retinal vein occlusion		retinal	artery	Branch	retinal	artery
				occlusion with resulting retinal oedema which has			oedema and dilated capillaries on surface of disc.
narrowed arterioles.
�	Cardiovascular system: Pulse and rhythm, BP, carotid
auscultation, cardiac auscultation, peripheral pulse when indicated.

3.
3.	The ESR should be measured for all patients. A high ESR

in patients over the age of 50 strongly suggests giant cell

arteritis, whereas in younger patients it may be associated	B)
	�	Anterior ischemic neuropathy (AION) is caused by

considered. Signs and symptoms- There is sudden loss of vision

and swelling of optic disc. Two forms of AION are


A)	�	Non arteritic AION: Peak incidence is in the 50-60 year
General features: malaise, weight loss, fever. Headache and scalp tenderness- typically painful to put head on pillow. Pain on chewing in severe cases and jaw claudication. Aches and pains from polymyalgia.

December, 2005	396		DOS Times - Vol. 11, No. 6