Vitreous

Question 1

Vitreous liquefaction

Answer 1

Vitreous liquefaction is the most common degenerative change in vitreous

Question 2

Causes of vitreous liquefaction

Answer 2

1. Degeneration-senile,myopic or retinitis pigmentosa
2. post inflammatory-fallowing uveitis
3. trauma to vitreous (mechanical)
4. thermal effect-fallowing cryocoagulation,photocoagulation,diathermy
5. radiation also

Question 3

Clinical features of vitreous liquefaction

Answer 3

Symptoms-

1. black floaters in front of eyes
2. ocular discomfort because of floaters

Sign-

1. opacities in vitreous
2. liquefaction with collapse
3. slit lamp biomircoscopy-absence of normal fibrillar structure & visible pockets of liquefaction which moves freely in vitreous

Question 4

Vitreous detachment

Answer 4

Posterior-
1.detachment anywhere posterior to vitreous base 
2.cause-liquefaction most common
3.more common in aphakic and myopic
4.clinical features
    • flashing of light
    • floaters
    • collapsed vitreous 
    • ring like opacity(weiss or fuch ring)
Anterior and base detachment-
1.anterior to base
2.blunt trauma,vitreous haemorrhage,anterior retinal dialysis & dislocated lens

Question 5

Complication of vitreous detachment

Answer 5

1 retinal break
2 vitreous haemorrhage
3 retinal haemorrhage and
4 cystoid maculopathy

Question 6

Vitreous opacities

Answer 6

1 muscae volitantes
2 persistent hyperplastic primary vitreous
3 inflammatory vitreous opacities 
4 vitreous aggregates & condensation liquefaction 
5 amyloid degeneration 
6 asteroid hyalosis
7 synchysis scintillans
8 red cell opacities 
9 tumour cell opacities

Question 7

Asteroid hyalosis

Answer 7

1 characterised by small white rounded bodies suspended in vitreous gel
2 formed due to calcium containing lipids
3 unilateral and asymptomatic
4 usually seen in old patients
5 has genetic relationship with diabetes and hypercholesterolaemia
6 genesis unknown
7 no effective treatment

Question 7

Synchysis scintillans

Answer 7

1 vitreous contain small white crystalline bodies formed from cholesterol
2 it effects damaged eyes which are suffered from trauma or inflammatory disease or vitreous haemorrhage
3 in this vitreous is liquid and crystals sink at bottom
4 opthalmic examination shows golden rain phenomenon
5 occurs at any age
6 symptomless
7 untreatable

Question 9

Vitreous haemorrhage cause

Answer 9

1 retinal tears pvd & rd
2 trauma- blunt or perforating
3 inflammatory diseases like eale’s disease & secondary to uveitis
4 vascular disorders CRVO & hypertensive retinopathy
5 metabolic disease like diabetes
6 blood dyscrasias
7 bleeding disorder
8 neoplasms like retinoblastoma and malignant melanoma
9 Other coats diseases

Question 10

Clinical features of vitreous haemorrhage

Answer 10

Symptoms-
•sudden development of floaters in small haemorrhage
• suddem painless loss of vision in large/massive haemorrhage

Sign-
•distant direct opthalmoscopy -black shadows against red glow in small haemorrhage & no red glow in massive haemorrhage
• direct and indirect opthalmoscopy-
Show blood in vitreous cabity
• ultrasonography- B scan helps in diagnosing

Question 11

Fate of vitreous haemorrhage

Answer 11

1 complete absorption
2 organisation of haemorrhage- formation of yellow debris
3 complications like vitreous liquefaction, khaki cell glaucoma & degenration
4 retinitis proliferans