TUTORIAL 4: flashes and floaters

Question 1

What are the differential diagnosis for floaters and flashes?

Answer 1

migraine-flashes
PVD- floaters and/or flashes
RD- floaters and/or flashes
Retinal degeneration-flashes
Uveitis

Question 2

What questions should you ask someone with floaters?

Answer 2

When did it start?
Which eye/ both eyes?
Any shadows or curtain in your vision?
Any trauma to the eye or head?
Any previous history of retinal detachment?
Any history of intraocular surgery?

Question 3

What is the difference in floaters between PVD and RD?

Answer 3

PVD: PHOTOPSIA
- temporal, vertically orientated, momentary flashes
-more noticeable in the dark
-white, silver, yellow or golden

RD: floaters
-sudden onset of shower suggests red blood cells or pigment cells

Question 4

What tests should you do to investigate flashes/floaters?

Answer 4

Measure visual acuity
-Reduced in RD if macula affected

Relative afferent pupillary defect

Reduced IOP

Visual field

Slit-lamp
-Anterior vitreous

Dilated fundus and vitreous examination with high-powered fundus viewing lens

Question 5

What slit lamp signs can you get for PVD?

Answer 5

Weiss Ring
Vitreous syneresis
shafers sign
vitreous hemorrhage

Question 6

SYSTEMIC DISEASES GIVE

Answer 6

BILATERAL RETINOPATHY