Eye Complaints

1. PREPARED BY:
ANIS SUZANNA BINTI MOHAMAD A123369
CHONG TENG CHOU A122615 SIAH SOO
KIONG A122506 OOI TING SHAN
A122573 PATRICIA LOW
A122679 NUR SYUHADA BT ALWI
A123526
Visual symptomology

2. Visual symptoms
1. Blurred Vision
2. Double vision
3. Vision loss
4. Photopsia
5. Hallucination
6. Floater
7. Colored halos around eye
8. Photophobia
9. Dazzling or glare
discomfort
10. Chromatopsia
11. Heightened color
perception
12. Nyctalopia(night
blindeness)
13. Hemeralopia (day
blindness)
14. Oscillopsia
15. Color blindness
16. Palinopsia
17. Visual agnosia
18. Ocular lateropulsion
19. Pain in and about eye
20. Headache

3. 1.Blurred vision
Loss of visual acuity with indistinct
detail.
Can be unilateral or bilateral.
Can be blur at near, blur at distance or
both
Magnitude of a patient’s complaint will
depend on many factors including
- the degree of defect
- type of visual task being undertaken
May result from eye injury, refractive
error, eye disease, improperly fitted
contact lens or use of certain drug.
Normal
Vision with
diabetic
retinopathy

4. History taking part
How long he has had the visual blurring.
Does it occur only at certain times?
Ask about associated signs and symptoms, such as pain or
discharge.
If visual blurring followed injury, obtain details of the
accident
Ask if vision was impaired immediately after the injury.
 Obtain a medical and drug history.

5. Etiology
Medical causes
 Brain tumor
 Cataract
 Concussion
 Corneal abrasion
 Conjunctivitis
 Corneal dystrophies
 Corneal foreign bodies
 Diabetic retinopathy
 Dislocated lens
 Eye tumour
 Glaucoma
 Hypertension
 Hyphema
 Iritis
 Migraine headache
 Multiple sclerosis (MS)
 Optic neuritis
 Retinal detachment
 Retinal vein occlusion (central)
 Senile macular degeneration
 Serous retinopathy (central)
 Stroke
 Temporal arteritis
 Uveitis (posterior)
 Vitreous hemorrhage

6. 2.Double vision
Diplopia
Mostly seen in binocular
anomaly
Can be unilateral or
bilateral
General cause is from
cornea, crystalline lens,
muscle, nerve and brain.
Double vision is not
normal and should be
reported promptly.

7. Etiology
 Cornea
Infections of the
cornea(herpes zoster or
shingles)
Uncommon complication
of LASIK surgery.
 Crystalline len
Cataract
 Muscle
Myasthenia gravis
Graves’ disease
 Nerve
Multiple sclerosis
Guillain-Barre syndrome
Uncontrolled diabetes
 Brain
Strokes
Aneuryms
Brain tumour
Increased pressure inside
the brain from trauma,
bleeding or infection

8. 3.Vision loss
Inability to perceive visual
stimuli
Can be sudden or gradual
and transient or
permanent
Range from slight
impairment to total
blindness
Age-related
Macular
degeneration
Normal
Vision
Glaucoma
Hemiapnosia

9. Etiology of sudden vision loss
 always a medical
emergency
Eye injury
Eye artery obstruction -
this cause and other
causes are a medical
emergency.
Retinal artery obstruction
Retinal vein obstruction
Eye blood vessel
thrombosis
Temporal arteritis
Retinal detachment
Amaurosis fugax
Stroke
TIA (Transient ischemic
attack)
Migraine
Optic neuritis
Vitreous hemorrhage
Acute glaucoma
Methyl alcohol poisoning
Hysteria
Brain injury
Blow to the head

10. Etiology of gradual vision loss
Cataract
Macular degeneration
Age-related macular
degeneration
Diabetic retinopathy
Glaucoma
Hypertension
Choroiditis
Retinitis pigmentosa
Trachoma
Field of Vision Loss in
Late Retinitis Pigmentosa
Loss of vision associated
with macular
degeneration

11. 4.Photopsia
Hallucinatory
perceptions such as
sparks, lights or colours
arising in the absence of
light stimuli and
observed when the eyes
are closed.
 Etiology:
posterior vitreous
detachment
migraine with aura
migraine aura without
headache
retinal break or
detachment
occipital lobe infarction
sensory deprivation

12. 5.Hallucination
Definition:
 Visual perception not
evoked by a light stimulus.
 Perceptions in a conscious
and awake state in the
absence of external stimuli
which have qualities of real
perception, in that they are
vivid, substantial, and
located in external
objective space

13. Etiology
Blind person (central or peripheral visual field loss)
Bilateral eye covering (after surgery)
Ocular lesions as retinal haemorrhage, glaucoma,
optic atrophy
Psychoses
Central nervous system lesion (Alzheimer disease)

14. 6.Floaters
 Floaters are little
"cobwebs" or specks that
float about in the field of
vision.
 Dots or filaments that
move with the movement
of eye
Etiology:
 Vitreous opacities
 Scotomatous defects
(retinal lesion, myopia)
 Corneal foreign body
reflection
 Carbon tetrachloride
poisoning
 Migraine

15. 7.Colored halos around lights
 Blue and violet are next
to the stimulating light
and red outermost.
 Etiology:
 Glaucoma-
A.acute-angle closure with streching of
the corneal lamellae
B.open-angle glaucoma-halo noted in
the awakening (IOP highest in
morning)
 Mucus on the cornea
 Corneal scar/ edema
 Krunkenberg spindle
 Lens opacities
 Vitreous opacities
 Haze of ocular media

16. 8.Photophobia
Defination:
 Painful intolerance of the
eyes to light.
 symptom of a primary
ocular disorder or
underlying
central nervous system
disorder
Etiology
 Aniridia
 ocular
(conjuctivitis,keratitis,
iritis)
 Albinism
 Total color
blindness(achromaptosia)
 Systemic disease
 Toxic cause
 Drug induced (digitoxin)

17. 9.Dazzling or glare discomfort
Definition:
 difficulty seeing in the presence of bright light such as
direct or reflected sunlight or artificial light such as
car headlamps at night.
Patient with glare
discomfort
Normal patient without
glare discomfort

18. Etiology
1. Altered pupillary
response
2. Asymmetric placement
of the IOL in relation to
the pupillary aperture
3. Corneal scars or foreign
bodies
4. Idiopathic
5. Drugs such as
chloroquine,acetazolam
ide, or trimethadione
(Tridone)
6. Emotional disorders
7. Following refractive
surgery
8. Lenticular changes

19. Definition: Etiology:
Abnormal condition in
which objects appear
falsely coloured.
It named depending
upon the colour seen.
1. Cone monochromatism
• Blue cone
monochromatism -
abnormal vision of
blue color
1. Drugs
2. Genetic
3. Macular degeneration
4. Optic neuritis
5. Retinitis pigmentosa
10.Chromatopsia

20. Classification of chromatopsia

22. 11.Heightened Color Perception
 1. Heightened color perception is due to drugs,
including the following:
dronabinol
ethionamide
hashish
LSD
lysergide
marihuana
mescaline
oxygen
psilocybin
tetrahydrocannabinol
THC
Sources from: Fraunfelder FT, Fraunfelder FW. Drug-induced ocular
side effects. Woburn, MA: Butterworth-Heinemann, 2001.

23. Usually happened in person with dementia

24. 12.Nyctalopia (Night Blindness)
Definition:
 a condition making it
difficult or impossible to
see in relatively low light.
 It is a symptom of several
eye diseases
Difficulty sees in darkness

25. Etiology
Vitamin A deficiency
retinitis pigmentosa
congenital night
blindness
Sorsby's fundus
dystrophy
pathological myopia
peripheral cortical
cataract
Oguchi disease
refractive surgery (RK,
PRK, LASIK)

26. 13.Hemeralopia
Definition:
Day blindness
 inability to see as distinctly in
a bright light as in dim one
 It can be described as
insufficient adaptation to
bright light.
 The retinas of those with day
blindness are unable to
process the light around them.
 This, in turn, intensifies the
sunlight so much that they
literally can't see anything
around them.

27. Etiology
1. Adie’s pupil
2. Albanism
3. Aniridia
4. Cohen Syndrome
5. Cone dystrophy-genetic
condition
6. Drugs:- Trimethadone
7. Cataracts
8. Trauma:- Brain injury
Ocular complications are listed as optic atrophy ,microphthalmia
,pigmentary chorioretinitis , hemeralopia (decreased vision in bright
light) , myopia , strabismus , nystagmus and iris/retinal coloboma.

28. 14.Oscillopsia
Defination:
 A visual disturbance in
which objects in
the visual field appear
to oscillate.
 The severity of the
effect may range from
a mild blurring to
rapid and periodic
jumping.

29. Etiology :
 loss of the vestibulo-
ocular reflex
involuntary eye
movements such
as nystagmus
impaired coordination in
the visual
cortex (especially due
to toxins)
 aminoglycoside
 Illusionary movement of enviroment
unilateral
bilatarel

30. 15.Color blindness
Definition:
 A.k.a color
vision deficiency
 the inability to
perceive differences
between some of
the colors that
others can
distinguish.

31. Color blindness
Deficiency in color vision can be due to:
Inherited
defects
- present from birth and
have genetic basis
- affect both eyes equally
- affect the entire visual
field
Acquired defects
-secondary to a
pathological state
-may affect one eye
-may affect part of the
visual field

32. Classification of color blindness

33. Ocular diseases which causes color vision
disturbances
Ocular diseases Color vision changes
Age-related maculopathy Blue-yellow defect
Retinal detachment Blue-yellow defect
Diabetic retinopathy Blue-yellow defect
Hypertensive retinopathy Blue-yellow defect
Papilledema Blue-yellow defect
Glaucoma Blue-yellow defect
Lesions of optic nerve &pathway Red-green defect
Papillitis Red-green defect
Optic neuritis Red-green defect

34. 16. Palinopsia
Visual disturbance that causes images to persist to some
extent even after their corresponding stimulus has left
These images are known as afterimages and occur in
persons with normal vision.
 A person with palinopsia experiences them to a
significantly greater degree, to the point where they
become difficult or impossible to ignore

35. Palinopsia : Symptoms

36. Causes
lesion
 parieto-occipital
 temporal-occipital areas as a result of a cerebral infarction,
epilepsy, tumour, or brain injury

37. 17.Visual agnosia
Visual agnosia is a neurological disorder
distinguished by the inability to recognize
familiar objects.
Types :
1)Appreceptive Agnosia
2)associative visual agnosia

38. Appreceptive Agnosia - Failure in high-level object
recognition despite normal vision
Symptoms :
 Pt are unable to recognize objects
 Unable to access the structure or spatial properties of a visual
stimuli
 Object is not seen as a whole.
 Cannot draw or copy things
Causes :
 damage in the lateral occipital area

39. Drawing Test Result

40. Associative visual agnosia
 inability to identify objects due to impaired
access to stored semantic information about the
objects.
Causes :
 lesion on the left occipital and temporal lobe,
often in conjunction with damage to the
posterior thalamus and limbic cortex.

41.  Criteria :
 Difficulty recognizing variety of visually presented
objects with their semantic meaning, or organize
objects into semantic categories.
 Normal recognition of objects from a verbal description
of it or when using sense other than vision (e.g. smell,
touch, taste).
 Elementary visual perception that is sufficient to copy
line drawings quite well but unable to identify objects
being copied

42. • copy line drawings quite well
• unable to identify objects being copied

43. 18.Ocular Lateropulsion
A strong forced conjugate deviation of the eyes to one
side.
a position bias of eye movements in the direction towards
the lesion
Symptoms :
 Unable to reach a laterally placed fixation target in a single
rapid eye movement (a single saccade)
 Patients overshoot towards the side of the lesion and undershoot in
opposite direction.
Cause :
 Asymmetrical lesion of the pons and lateral medullar

45. 19.Pain In and About Eye
 Symptoms
 burning, throbbing, aching, or stabbing sensation in or around the eye.
 feel as if there is a foreign body in the eye.
 Causes
 Burns
 Conjunctivitis (pink eye) or any inflammation of the upper and lower lids
 Contact lens complications
 Eye problems (infection, irritation, or injury such as a corneal abrasion)
 Eye surgery
 Glaucoma
 Migraine headache
 Sinus problems
 Stye (hordeolum)
 Viral infections such as the flu

46. 20.Headache
Headaches often appear centered
around the eyes or behind the eyes.
Symptoms :
 referred area of the pain is around
the
eyes.
 a brow ache or an ache behind the
eyes.

47. Causes :
• Eyestrain - overworking of the focusing muscle within
the eye.
• Contact lens related problems - headache may come
from a poorly fitting, tight lens, corneal infection or
swelling, or from a lack of oxygen in the cornea.
• Corneal ulcer
• Conjunctivitis
• Dacryocystitis - an infected tear drainage sac (inside
corner of the eye) can lead to pain and headache
• Glaucoma (acute)
• Optic neuritis - inflammation of the optic nerve can
cause headache and pain on eye movement along with
blurred vision

48. -THE END-