Management

Question 1

What’s the referring protocol for vein occulsions?

Answer 1

They should be referred urgently and recommended that the optom rings the opthal and discuss how urgently the px should be referred

Question 2

Besides calling the opthal what other management plan should be in place for the px?

Answer 2

They require an app with their gp to address underlying cardiovascular diseases. They should also recommend lifestyle change and medical management

Question 3

What is the treatment for neovasc

Answer 3

Prp laser photocoagulation therapy which destroys the damaged retinal cells that tried to vascularise ischemic tissue

Question 4

Around what timeframe does neovasc appear

Answer 4

6-12 months but can appear as late as 1-3 years.

Question 5

What is the process of macula oedema

Answer 5

An occlusion is due to thrombosis which then causes an increase of capillary pressure which then leads to an increase of permeability allowing fluid and plasma to leak into retina

Question 6

What leads to visual impairment with macula oedema

Answer 6

Build up of fluid leads to thicken of retina leading to mechanical distortions in the neural tissue leading to visual impairment

Question 7

What increases the risk of fovea damage with regards to oedema

Answer 7

The longer the time the px has oedema the more damage done

Question 8

Why is the laser treatment delayed for 3 months?

Answer 8

To give the oedema a chance to spontaneously recover

Question 9

What is the treatment for macula oedema

Answer 9

Anti VEGF injections

Question 10

What would occur if there was no treatment of neovasc?

Answer 10

No treatment could lead to bleeding leading to a pre retinal haemorrhage which has poor prognosis