Visual Dysfunction
Cataracts (most common cause), Retinal detachment Glaucoma (buildup of pressure in anterior chamber before Canal of Schlemm) Retinitis Pigmentosa (younger people, poor night vision, often present as clumsy or accidentprone)
Visual Dysfunction
Macular degeneration Presbyopia Migraine, Vitreoretinal traction Glaucoma, corneal disease Amaurosis fugax (thrombus in retinal artery, pt describes that a curtain goes up when thrombus dissolves) Multiple sclerosis (30-40 y.o) Papilledema
Flashes of light
Visual Dysfunction
Diplopia (monocular):
Cataracts (unilateral) Refractive error Vascular, tumor, myasthenia gravis, multiple sclerosis Migraine Macular degeneration
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Diplopia (binocular):
Distorted vision:
Facial Pain
Neuralgias:
Glossopharyngeal
Rare, related to swallowing and movement of pharynx
Sphenopalatine ganglioneuralgia
Brain-freeze, Ice-cream headache
Facial Pain
Hyperthyroidism (due to exophthalmos; what is the BP?) Sjgrens Syndrome (autoimmune attack of exocrine glands that produce tears and saliva) Retro-orbital = headache, tumor UTI = Reiters Syndrome
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Facial Pain
History clues:
1) Short, sharp recurrent pain = neuralgias 2) Deep, dull pain worse with bending forward or atmospheric changes = sinusitis 3) Pain radiating from front of ear and with opening the mouth = TMJ dysfunction 4) Pain with chewing or hot/cold foods = dental problems or brain freeze
Open-angle glaucoma
Etiology unknown; patient often describes that the peripheral field of vision has been cut (usually the nasal half) Usually presents bilaterally Patients often predisposed after past eye surgery or trauma Evaluation in chiropractic setting is difficult (elevated intraocular pressure not indicative)
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Retinitis pigmentosa
Affects children and young adults (child reports or parents notice decreasing night vision) Hereditary condition (degeneration of the retinal rods occurs, peripheral ring scotoma) Dark pigmentation of central retina, yellow waxy disc observed on fundoscopy Genetic counseling recommended
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