Abnormal fundoscopy Flashcards
What are features of non-proliferative diabetic retinopathy?
- Microaneurysms (dots)
- Haemorrhages (blots)
- Venous beading
- Intraretinal microvascular abnormalities (IRMAs)
- Hard exudates
- Cotton wool spots
How would you manage diabetic retinopathy?
- Panretinal photocoagulation - both proliferative and non-proliferative
- Focal/grid laser photocoagulation
- Intraviteral anti-VEGF
- Optimise diabetic control
What are retinal features of grade 1 hypertensive retinopathy?
Arteriolar narrowing
What are retinal features of grade 2 hypertensive retinopathy?
- Arteriolar narrowing
- AV nipping
- Silver/copper wiring
What are features of grade III hypertensive retinopathy?
- Arteriolar narrowing
- AV nicking
- Silver wiring
- Retinopathy - flame haemorrhages, hard exudates, cotton wool spots
What are retinal features of grade IV hypertensive retinopathy?
- Arteriolar narrowing
- AV nicking
- Silver wiring
- Retinopathy - flame haemorrhages, hard exudates, cotton wool spots
- Papilloedema
How would you manage Hypertensive retinopathy?
Treat hypertension
What are symptoms of retinal artery occlusion?
Sudden painless loss of all vision (central) or part of vision (branch)
What are features of retinal artery occlusion on fundoscopy?
- Swollen, pale (oedematous) retina
- Cherry red spots - macula
How wuld you manage retinal artery occlusion?
Reduce IOP within 6 hours
What are features of retinal vein occlusion on fundoscopy?
- Tortuous dilated vessels
- Widespread retinal flame haemorrhages
- Optic disc oedema
How would you manage retinal vein occlusion?
- No specific treatment
- Photocoagulation - for neovascularisation
What are the 4 F’s of retinal detachment?
- Floaters
- Flashes
- Fall in acuity
- Field loss
What are features of retinal detachment on fundoscopy?
Grey opalescent retina, ballooning forward
how owuld you manage REtinal detachment?
- Surgical vitrectomy
- Cryopexy/laser retinopexy
What symptoms might someone with AMD report?
Progressive central visual loss
What are features of dry AMD on fundoscopy?
Druesen in macula area - tiny white/yellow deposits
How would you manage dry AMD?
- Stop smoking
- Antioxidant supplements
What are features of wet AMD on fundoscopy?
- Subretinal haemorrhage in/around macula
- Localised retinal elevation and retinal oedema
How would you manage wet AMD?
- Intravitreal Anti-VEGF
- Photodynamic therapy
- Laser photocoagulation
What are symptoms of optic neuritis?
- REduced visual acuity
- Loss of red colour viison
- Central scotoma
- RAPD
What are features of optic neuritis on fundoscopy?
Unilateral swollen optic disc
How would you manage optic neuritis?
Methylprednisolone - MS most common cause
What symptoms might someone with Papilloedema have?
- Signs of raised ICP
- Vision usually normal
What are features of papilloedema on fundoscopy?
Bilateral swollen optic disc
How would you manage papilloedema?
Treat the cause
What are symptoms of chronic open angle glaucoma?
Asymptomatic until vision severely impaired
What are features of chronic open angle glaucoma?
- Optic disc cupping
- Optic disc atrophy
How would you manage chronic open angle galucoma?
- B-blocker eye drops
- Prostaglandin eye drops
- Alpha-agonist eye drops
- Carbonic anhydrase inhibitor drops
- Laser trabeculoplasty
What are symptoms of acute angle closure glaucoma?
- Eye pain/haedache
- Halos and blurring
- Red eye
What are features on fundoscopy of acute angle closure glaucoma?
- Ciliary flush + mid dilated irregular pupils
- Optic disc cupping
How would you manage acute angle glaucoma?
- IV/PO acetazolamide
- Pilocarpine
- Timilol
- Consider mannitol/oral glycerol
