virtual clinic session Flashcards
what investigations would you do?
and what is the likely diagnoses?
From most important to least:
- visual acuity
- pupils
- slit lamp
- fluorescein stain
-Metallic foreign body
what is management for metallic foreign body?
- remove it!!!
- clorophene?? ointment for a week to help heal it
-only abduction is working
which allied health professional may you ask for help?
differentials?
next steps?
- orthopotist
- CNIII palsy
-imaging (CT/MRI)
what is the diagnoses?
-age related macular degeneration (ARMD)
what allied health professional may help in ARMD?
-opthalmic imaging technician who could do an OCT scan
what is the UKs most common cause of blindness?
-age related macular degeneration
what is age related macular degeneration?
Age-related macular degeneration is a condition where there is degeneration in the macula that cause a progressive deterioration in vision.
what are the two types of ARMD?
- wet (10%)
- dry (90%)
what are the 4 layers of the macula?
- choroid layer (bottom)
- Bruch’s membrane
- retinal pigment epithelium
- photoreceptors (top)
describe what you see and what is the diagnoses?
-basal cell carcinoma
what is the diagnoses?
-most likely is inflammation in the anterior section
what is usually seen on fundoscopy for age related macular disease?
- drusen seen on funcdoscopy
- drusen are yellow deposits of proteins and lipids that appear between the retinal pigment epithelium and Bruch’s membrane
what are drusen?
-yellow deposits of proteins and lipids that appear between the retinal pigment epithelium and Bruch’s membrane
what are some features of both wet and dry AMD?
- drusens
- atrophy of the retinal pigment epithelium
- degeneration of the photoreceptors
what occurs in wet AMD?
- there is a development of new vessels growing from the choroid layer into the retina
- these vessels can leak fluid or blood and cause oedema and more rapid vision loss
-a key chemical that stimulates the development of new vessels is the vascular endothelial growth factor (VEGF) and this is the target of medications to treat wet AMD
what are risk factors for AMD?
- increase in age
- smoking
- white or Chinese ethnic origin
- family history
- cardiovascular disease
how does AMD present?
- gradual worsening of central vision loss
- reduced visual acuity
- crooked or wavy appearance to straight lines
Wet AMD presents more acutely. It can present with a loss of vision over days and progress to full loss of vision over 2-3 years. It often progresses to bilateral disease
what is management for wet AMD?
anti-VEGF medications (e.g. ranibizumab, bevacizumab and pegaptanib)
what sort of squint is this?-
-left esotropia
if it was turning out it would be left exotropia
