Disorders of the retina Flashcards
Causes of retinal detachment (4)
rhegmatogenous: vitreal detachment>retinal tear>detachment
secondary to intraocular problem: exudative (tumour) or tractional (fibrous bands in vitreous in DM)
after surgery
trauma
(myopic eyes at greater risk of detachment)
Process and prevention of retinal detachment
holes/tears in retina allow fluid to separate neurosensory retina from the retinal pigment epithelium.
can be prevented by cro/laser retinopexy when retinal damage is identified
Presentation of retinal detachment (6)
PAINLESS
4 Fs:
- floaters
- flashes
- field loss
- fall in acuity: may be like curtain coming down
in extensive detachment, ,the macula is pulled off>central visual loss
Fundoscopical features of retinal detachment
grey, opalescent retina ballooning forward
Ix for retinal detachment
fundoscopy w. pupil dilated
Mx of retinal detachment (3)
SURGERY:
- vitrectomy w. gas tamponade
- scleral silicone implants
- cryotherapy/laser coagulation used to secure retina.
Features of retinitis pigmentosa
most common inherited retinal degeneration
AR most common
AD more severe
X-linked most severe
Pathology of retinitis pigmentosa (3)
progressive degeneration of rods in the retina => periphery of retina mainly affected
damage to adjacent retinal pigment epithelium
leads to subsequent damage to cone cells
Dx and fundoscopy of retinitis pigmentosa (5)
decreased acuity
NIGHT BLINDNESS
decreased fields and tunnel vision
fundoscopy:
- pigmented, bone specule-shaped deposits
- macula spared
Retinal effects of toxoplasmosis (2)
may cause punched out, hyperpigmented, chorioretinal scars
may lead to decreased acuity.
Retinal vasculitis features, causes and fundoscopy (3)
inflammation of vascular branches of retinal artery
caused by inflammatory processes or vasculitides e.g. bechet’s, MS, sarcoid
fundoscopy shows “candle wax” retina
Definition of macular holes
full thickness retinal hole involving fovea>decreased acuity
Presentation of macular holes (3)
presents w. distorted images and visual loss
fundoscopy shows punched out area at centre of macula which may have small yellow deposits (looks like syphilis)
slit lamp shows well defined hole interrupting the beam which is typically surrounded by a grey halo of retinal detachment.
Ix for macular holes (3)
Amsler grids
Optical coherence tomography for Dx and staging
fluorescin angiography helps differentiate between cystoid macular oedema and choroidal neovascularisation
Mx of macular holes (
in early stages just monitor
if advanced:
- vitrectomy
- gas bubble introduced to reposition macula
- patient needs to spend 1-2wks post-op face down
- complications:cataracts, retinal tears/detachment
