6.1.12 Flashcards
What is Retinal Detachment?
A medical emergency where the retina separates from the underlying tissue, potentially leading to permanent vision loss.
What are the three main types of retinal detachment?
- Rhegmatogenous Detachment
- Tractional Retinal Detachment
- Exudative Retinal Detachment
What causes Rhegmatogenous Detachment?
A tear or hole in the retina allows fluid to seep underneath, lifting the retina away.
What is Tractional Retinal Detachment?
Occurs when scar tissue pulls the retina away from its normal position, often seen in diabetic retinopathy.
What is Exudative Retinal Detachment?
Fluid accumulates beneath the retina due to inflammation, tumors, or vascular issues without a retinal tear.
What are common symptoms of Retinal Detachment?
- Sudden blurry vision
- Flashes of light (Photopsia)
- Floaters
- Loss of peripheral vision
- Preserved central vision until macula affected
What risk factors increase the likelihood of developing Retinal Detachment?
- Myopia (Nearsightedness)
- Previous retinal detachment
- Family history
- Trauma/Injury to the eye
- Diabetes
- Age (over 50)
What is the recommended action for someone showing symptoms of Retinal Detachment?
Urgent referral to a hospital eye service is necessary, ideally within 24 hours.
What are the management options for Retinal Detachment at the hospital?
- Laser Retinopexy
- Cryotherapy
- Pneumatic Retinopexy
- Vitrectomy
What is Laser Retinopexy?
A procedure using a laser to create burns around the retinal tear, sealing it back to the underlying tissue.
What is Cryotherapy in the context of Retinal Detachment?
Freezing is applied around the retinal tear to create adhesion between the retina and underlying tissue.
What does Pneumatic Retinopexy involve?
Injecting a gas bubble into the eye to press against the detached retina, helping it reattach.
What is Vitrectomy?
A surgical procedure where the vitreous gel is removed and replaced with fluid to help reattach the retina.
How can Retinal Detachment be explained in layman’s terms?
The retina is like wallpaper at the back of the eye that can peel off, leading to vision problems.
What is Shafer’s Sign?
The presence of pigment cells from the retina in the anterior vitreous, indicating a retinal tear or detachment.
What causes Shafer’s Sign?
- Retinal Tear or Hole
- Rhegmatogenous Retinal Detachment
- Vitreous Syneresis
- Trauma
What does the presence of Shafer’s Sign suggest?
It indicates a retinal tear and potentially a developing rhegmatogenous retinal detachment.
True or False: Not every retinal detachment will exhibit Shafer’s Sign.
True
What technique is used to check for Shafer’s Sign?
The slit lamp technique
This technique involves high magnification and a narrow beam of light focused on the anterior vitreous.
What is the initial step in setting up the slit lamp for Shafer’s Sign examination?
Use a narrow, low intensity slit beam (1-2 mm in width)
The slit lamp should be angled to illuminate the anterior vitreous and posterior chamber.
What should be examined in the anterior vitreous when checking for Shafer’s Sign?
Presence of small pigment granules or black flecks
These indicate retinal pigment epithelium cells in the vitreous due to retinal tears or detachment.
What magnification is typically used to visualize pigment cells during the slit lamp examination?
16x to 25x
High magnification is necessary to better visualize tiny pigment cells.
What additional tools can be used for indirect examination if necessary?
Gonioscopy lens or 90D/78D lens
These are used for viewing the posterior vitreous and retina in greater detail.
What condition is the detection of Shafer’s Sign particularly important for?
Rhegmatogenous retinal detachments
The presence of pigment cells in the vitreous is a strong indicator of this condition.
How does Shafer’s Sign typically appear in the vitreous humor?
As small, dark spots or flecks
These are key findings in diagnosing retinal pathology.
What technique is used to check for Shafer’s Sign?
The slit lamp technique
This technique involves high magnification and a narrow beam of light focused on the anterior vitreous.
What is the initial step in setting up the slit lamp for Shafer’s Sign examination?
Use a narrow, low intensity slit beam (1-2 mm in width)
The slit lamp should be angled to illuminate the anterior vitreous and posterior chamber.
What should be examined in the anterior vitreous when checking for Shafer’s Sign?
Presence of small pigment granules or black flecks
These indicate retinal pigment epithelium cells in the vitreous due to retinal tears or detachment.
What magnification is typically used to visualize pigment cells during the slit lamp examination?
16x to 25x
High magnification is necessary to better visualize tiny pigment cells.
What additional tools can be used for indirect examination if necessary?
Gonioscopy lens or 90D/78D lens
These are used for viewing the posterior vitreous and retina in greater detail.
What condition is the detection of Shafer’s Sign particularly important for?
Rhegmatogenous retinal detachments
The presence of pigment cells in the vitreous is a strong indicator of this condition.
How does Shafer’s Sign typically appear in the vitreous humor?
As small, dark spots or flecks
These are key findings in diagnosing retinal pathology.
What is Gonioscopy?
A diagnostic procedure used to examine the anterior chamber angle of the eye
Specifically examines the area where the cornea and iris meet, crucial for aqueous humor drainage.
What conditions is Gonioscopy typically performed to assess?
Conditions related to glaucoma, such as angle-closure glaucoma
Also evaluates the drainage system of the eye for other abnormalities.
What does Gonioscopy allow eye care professionals to observe?
Trabecular meshwork, scleral spur, and iris structures within the anterior chamber angle
Helps detect blockages or narrowing of the drainage angle.
What is the significance of the anterior chamber angle in Gonioscopy?
Crucial for the drainage of aqueous humor and assessing glaucoma risk
Narrowing can lead to increased intraocular pressure.
How is Gonioscopy performed?
Using a slit lamp with a goniolens after applying a topical anesthetic
The goniolens provides a view of the anterior chamber angle.
What types of lenses are used in Gonioscopy?
Goldmann Lens, Shaffer’s Grading System, Koeppe Lens
Each lens has specific features for examining the anterior chamber angle.
What is the Goldmann Lens used for?
High magnification of the anterior chamber angle
Allows thorough assessment of angle anatomy.
What is the Shaffer’s Grading System?
A system that rates the openness of the anterior chamber angle from Grade 0 (closed) to Grade 4 (open)
Helps in classifying the drainage angle condition.
What is the risk associated with closed-angle glaucoma?
Prevents proper fluid drainage, increasing intraocular pressure
Gonioscopy assesses the risk for this medical emergency.
What differentiates open-angle glaucoma from closed-angle glaucoma?
Open-angle glaucoma has an open angle but impaired trabecular meshwork function; closed-angle glaucoma has a narrow or closed angle
Both conditions lead to increased intraocular pressure.
What other conditions can Gonioscopy evaluate?
Iridocorneal endothelial syndrome, traumatic angle recession, neovascular glaucoma
Offers insights into various ocular conditions related to the anterior chamber.
True or False: Gonioscopy can help determine the type of glaucoma.
True
It helps classify the condition based on the angle’s status.
Fill in the blank: Gonioscopy helps detect _______ or narrowing of the drainage angle.
blockages
Essential for preventing increased intraocular pressure.
