Common Causes of Vision Loss

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Jacob Benson
5 years ago
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1 Common Causes of Vision Loss

Learning Objectives To identify the most common causes of vision loss in the United States To differentiate the most common forms of agerelated macular degeneration and diabetic

2 Learning Objectives To identify the most common causes of vision loss in the United States To differentiate the most common forms of agerelated macular degeneration and diabetic retinopathy To apply the AAO eye examination guidelines to patients with diabetes To advise patients on ways to reduce their likelihood of developing visually significant cataracts

3 Common Causes of Vision Loss Age-Related Macular Degeneration Diabetic Retinopathy Glaucoma Cataract

4 AMD Leading cause of legal blindness in U.S. Difficulty with fine visual acuity Unable to read, recognize faces Unable to drive and perform other ADL Rarely effects peripheral vision

5 AMD-Risk Factors Age Family history of macular degeneration Hypertension Cardiovascular risk factors Smoking Other???

6 AMD-Classification Nonexudative or dry Exudative or wet

7 AMD- Dry

8 Atrophy

9 AMD- Wet

10 Choroidal Neovascularization

11 Fibrovascular Scar

13 AMD-Treatment Observation Antioxidant Supplementation Zinc, Vitamins A, C, E (AREDS I)??? Role of lutein, others (AREDS II) Quit smoking and improve general health Low vision rehabilitation

14 AMD-Treatment Laser Photocoagulation Photodynamic Therapy Anti-angiogenic Medications

15 AMD-Laser Photocoagulation

16 AMD-Photodynamic Therapy

17 Anti-Angiogenic Medications

18 Diabetic Retinopathy Leading cause of blindness among working- age Americans (20-65 yrs) Significant cause of visual loss in elderly Most blindness can be prevented with early detection and treatment

19 Risk Factors for Diabetic Retinopathy Duration of diabetes Quality of diabetes control Hypertension Hyperlipidemia Renal disease Fluid overload states Pregnancy

20 Diabetic Retinopathy Nonproliferative Diabetic Retinopathy Proliferative Retinopathy

21 Nonproliferative Diabetic Retinopathy

22 Nonproliferative Diabetic Retinopathy

23 Proliferative Diabetic Retinopathy

24 Proliferative Diabetic Retinopathy

25 Treatment Intensive control reduces development and progression of retinopathy Control of associate risk factors equally important! Laser reduces risk of visual loss from: diabetic macular edema proliferative diabetic retinopathy neovascular glaucoma

26 ABC Targets Hemoglobin A1c- < 7.0% Blood Pressure- <130/80 mm Hg Cholesterol- LDL < 100 mg/dl

27 Diabetic Macular Edema-Control

28 Diabetic Macular Edema-Laser

29 Diabetic Macular Edema-Meds

30 Proliferative Diabetic Retinopathy

time of diagnosis then yearly Prior to pregnancy if

31 Diabetic Retinopathy Screening Guidelines Type 1-five years after onset then yearly Type 2-at the time of diagnosis then yearly Prior to pregnancy if possible (1 st trimester) More frequent follow up as needed

32 The Glaucomas Congenital Glaucoma Primary Open Angle Glaucoma Angle Closure Glaucoma Secondary Glaucoma

33 Primary Open Angle Glaucoma Significant cause of blindness in US The leading cause of blindness in African American population Patients may experience profound loss of vision before symptoms develop

34 Primary Open Angle Glaucoma Risk Factors High intraocular pressure Family history of glaucoma Age?Cardiovascular risk factors?diabetes mellitus?myopia

35 Primary Open Angle Glaucoma Chronic, bilateral (but often asymmetric) condition characterized by: Optic disc abnormalities Visual field loss Elevated intraocular pressure Normal-appearing anterior chamber angles

36 Normal Aqueous Flow

37 Visual Field Loss

38 Normal Optic Disc

39 Glaucomatous Optic Disc

40 Glaucoma Management General Principles Lower intraocular pressure Reduce optic disc damage Reduce visual field loss

41 Glaucoma Management Treatment Options Medications Laser Photocoagulation Surgery

43 Cataract A leading cause of vision loss in the US Most common cause of blindness worldwide More than 1.5 million cataract surgeries performed each year

44 Cataract Progressive loss of vision Glare Loss of contrast sensitivity Loss of binocular visual function

45 Cataract

46 Cataract Risk Factors Advancing age Ultraviolet light exposure Corticosteroid use Diabetes mellitus Ocular inflammation/trauma/surgery Smoking

47 Cataract

48 Cataract Surgery

49 Common Causes of Vision Loss Age-Related Macular Degeneration Diabetic Retinopathy Glaucoma Cataract

NEPTUNE RED BANK BRICK

NEPTUNE RED BANK BRICK Diabetes & The Eye Diabetics are more likely to develop Cataracts at a younger age. Diabetics are twice as likely to develop Glaucoma when compared to non-diabetics. The primary