Trans 012 Disturbances In Vision

Question 1

Where does Retinal detachment occur?

Answer 1

Detachment occurs in the subretinal space (between RPE layer and rods & cones

Question 2

Types of Retinal detachment

Answer 2

Non rhegmatogenous: fraction and exudative

Rhegmatogenous.

Question 3

What type of Retinal detachment

 There is a leak in the blood vessels
• Breakdown of integrity of the vascular system of choroid and
/or retina
o Eclampsia&pre-eclampsia
o Tumorsofchoroidandretina
o Intraocular inflammation: choroidal effusion
▪ Vogt Koyang Harada Disease o Collagen Disease

Answer 3

Exudative detachment

Question 4

 May humila sa retina kaya umangat
• Ischemic retinal disease causing fibroproliferative membrane
formation
o Diabetic Retinopathy
o Central Retinal Vein Occlusion (CRVO), Branch Retinal
Vein Occlusion (BRVO)
• Intraocular inflammation causing membrane formation
• Rhegmatogenous retinal detachment with proliferative
vietreoretinopathy (traction membranes)

Answer 4

TRACTION DETACHMENT

Question 5

What retinal detachment has this symptom Symptoms:
o Blurry wavy vision, visual fields cuts, floaters and flashes
preceding blurry vision, NO PAIN, absence of symptoms is possible

• Pathophysiology
o Presenceofretinalbreak

o Theremaybevitreoustractiontotheretinalbreak
o Accumulation of fluid between RPE and photoreceptors

Answer 5

Take note: Pag nasa taas ang butas, retinal detachment is faster rhegmatogenous Retinal detachment

Question 6

StageI:mildtomoderatearteriolarnarrowingorsclerosis
o Stage II: Moderate to marked arteriolar narrowing, with
focal or generalized narrowing, exaggerated light reflex,
and AV crossing changes
o Stage III: the above PLUS cottonwool spots, hard
exudates, retinal hemorrhages, extensive microvascular
changes, retinal edema
o StageIV:theabovePLUSdiscedema

What staging?

Answer 6

Keith Wagener Barker Staging of Hypertensive Retinopathy

Question 7

W’hat stage in
Barker staging has

AV crossing changes

Answer 7

Stage 2

Question 8

W’hat stage in

Barker staging has Cotton wool spots

Answer 8

Stage 3

Question 9

W’hat stage in

Barker staging has disk edema

Answer 9

Stage 4

Question 10

Av nicking versus venous elevation versus venue deviation

Answer 10

If an artery which is a thick muscular coat crosses a vein plus the effect of hypertension the changes in the wall will be harder. It will cause narrowing of the tips of the vein “pencil point” AV nicking
 The vein cross to the hard artery, the vein will be elevated. Venous elevation
 If the artery cross the vein it might delineate the path of the vein. Venous deviation

Question 11

Deflection of retinal vein as it crosses the

arteriole.

Answer 11

Salus’ sign

Question 12

Tapering of the retinal vein on either side

of the AV crossing.

Answer 12

Gunn’s sign

Question 13

BankingoftheretinalveindistaltotheAV

crossing.

Answer 13

Bonnet’s sign

Question 14

Causes
o Hypertension, arteriosclerosis, diabetes mellitus,
inflammation, collagen disease, hyperviscosity
syndromes
• Symptoms/signs
o Sudden painless blurring of vision, afferent pupillary defects

what disease?

Answer 14

Central Retinal vein occlusion

Question 15

Treatment of the central Retinal vein occlusion if there is swelling of the macula

Answer 15

if there is swelling of the macula we inject

Anti-VEGF(vascular endothelial growth factor) medication

Question 16

Causes:
o Emboli, thrombi, hemorrhage under an atherosclerotic
plaque, inflammation, spasm, dissecting carotid artery aneurysm, hypotension, hypertensive arterial necrosis, prolonged pressure on the globe
• One of the only 2 TRUE ophthalmologic emergencies!  The other one is chemical burns of the cornea
• Treatment:
o Loweringeyepressurestat,toimproveocularbloodflow  How to be resolve within 5 minutes

 Can also have a branch occlusion

Answer 16

CENTRAL RETINAL ARTERY OCCLUSION

Question 17

Risk factors of having diabetic retinopathy

Answer 17

Risk Factors
o DurationofDiabetes
o Glycemic control
o Age
o Type of diabetes
o Family Hx of DM
o Blood pressure
o Serum lipids
o Nutritional Factors/Obesity o Clotting Factors
o Renal Disease

Question 18

Types of diabetic retinopathy

Answer 18

Non proliterative and proliterative

Question 19

Mild, Moderate, Severe, Very Severe microaneurysms, retinal hemorrhages and hard and soft exudates, venous beading, IRMAs

Symptoms:
o Variablevisualdeficits/floaters
o Normal20/20visionpossible

Answer 19

Non proliterative

Question 20

Early, High Risk
o Retinal and disc neovascularization (NVE & NVD),
vitreous and pre-retinal hemorrhages, fibrovascular membranes

Answer 20

Proliferative Dr

Question 21

If there is macular

Edema, will there be loss of vision?

Answer 21

Yes

Question 22

induces regression of new vessels and reduces the
incidence of severe visual loss from proliferative diabetic
retinopathy by 50%. Several thousand regularly spaced laser burns are
applied throughout the retina outside the vascular arcades to reduce the angiogenic stimulus from ischemic areas

Answer 22

Pan-retinal photo-coagulation (prp)

Question 23

Treatment for macular edema

Answer 23

• Intravitrel anti-VEGF injections

Question 24

Reason for proliferation in diabetic retinopathy

Answer 24

Lack of oxygen

Question 25

The most common hereditary retinal dystrophy

Answer 25

RETINITIS PIGMENTOSA

Question 26

Clinical Manifestations
• Nyctalopia or night blindness
• Problems with peripheral vision
• Deteriorating vision
• Prolonged dark adaptation
• Contracted visual fields
• Abnormal ERG (Electroretinogram)

what disease?

Answer 26

RETINITIS PIGMENTOSA

Question 27

Classic triad of retinitis pigmentosa

Answer 27

classic triad of findings comprises of bone-spicule retinal pigmentation, arteriolar attenuation, and ‘waxy’ disc pallor.

Question 28

most common malignancy in childhood

Answer 28

Retinoblastoma

12-18 months to 5 years old

Question 29

2 types retinoblastoma

Answer 29

hereditary and sporadic

Question 30

Most common presenting sign retinoblastoma

Answer 30

leukocoria

Question 31

abnormality noted in the “retinoblastoma gene” at the q14

locus

Answer 31

Ch 13

Question 32

The most accepted treatment now for retinoblastoma

Answer 32

chemotherapy and debulking chemotherapy.

Question 33

Innermost layer of the choroid

Answer 33

Bruch’S membrane

Question 34

occlusive microvasculopathy characterized by multiple
retinal white areas around the optic nerve head and fovea
with paravascular clearing which may be associated with
intraretinal hemorrhages.

Answer 34

PURSTCHER’S RETINOPATHY

Question 35

It involves the choroid, Bruch membrane and retinal pigment epithelium
 Direct ruptures are located anteriorly at the site of impact and run parallel with the ora serrata

Answer 35

Choroidal rupture