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Study Guide

The document provides descriptions of 10 different eye conditions that may be observed during an eye exam: 1. A normal eye fundus with descriptions of common structures like the macula and optic disc. 2. Hypertensive retinopathy characterized by arterial constriction, atherosclerosis, hemorrhages, cotton wool spots, and vein occlusion. 3. Early diabetic retinopathy seen as microaneurysms, hemorrhages, and hard exudates scattered around the retina. It provides brief descriptions of the signs and symptoms seen for each condition.

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43 views

Study Guide

The document provides descriptions of 10 different eye conditions that may be observed during an eye exam: 1. A normal eye fundus with descriptions of common structures like the macula and optic disc. 2. Hypertensive retinopathy characterized by arterial constriction, atherosclerosis, hemorrhages, cotton wool spots, and vein occlusion. 3. Early diabetic retinopathy seen as microaneurysms, hemorrhages, and hard exudates scattered around the retina. It provides brief descriptions of the signs and symptoms seen for each condition.

Uploaded by

tnim.ds
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© © All Rights Reserved
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Download as PDF, TXT or read online on Scribd
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MlJ STUDY GUIDE

I~
1. normal
The color of the fundus is brown or orange. A slight ly dark spo t in the middl e is the macula. At
the portion 15 degrees nasall y from the ce nter on the hor izontal axis, there is th papilla of the
optic nerve whic h is circ ular or slightly elliptical shaped and has a slightly brighter tinge. The
border betwe en the papilla and the surro undi ng retina is clearly defined . Th e center o f the
pa pilla is indented and bright er than the periph ery (excavati o pap illae), and appea rs pale yellow.
The area o f the inde ntation is less than 60% of the tota l area of the papilla, and the retinal
arteries and veins ex tend upward and downwa rd nasally and aura lly from the pap illa's nasal side.
On the nas al side, they run straight. The fine arter ies and vei ns ru nni ng from the papill a to the
......~~_ ~~~ .... macu la run stra ight. The arteries are brigh t red and the ve ins are darker, and in the center of the
arteries ap pears a wh ite linear refl ection abou t 40 or 45% of the artery in width. The di ameter of
the art ery is from 2/3 to 3/4 that of the vei n.

2. hypertensive retinopathy
Arter ial vasoco nstriction grade 3, ar terios cleros is gra de 1, hemorrh age s, co tton wool spo ts, and
simp le vei n concealment.
The dia meter of the constricted arteries is irre gular and less than hal f that of the correspo nding
veins. Spotty hemorrha ge s are scattered. Soft ex uda tes (co tto n-wo ol patches) exhibit localized
insu fficie nt b lood supp ly of the op tica l nerve tissue. Simpl e ve in concea lment appea rs at the
crossings o f ar tery and vein.

3. simple/background diabetic retinopathy


m icroaneu rysms, hemorrh ages and hard exu dates

Spotty hemorrhages arc scattered aro und . Th e extremely small red dots are microaneurysms,

an d the ha rd exu dates are also apparen t.

4. papilledema (chronic phase)


Ca used by ch ronically inc reased intracranial press ure. Th e papilla of the optic nerve swe lls and
protrudes in to the vitreous bod y. Th e ap ical inde nta tion of it (ex cavatio pa pillae) disapp ears, and
the boundary betwee n the papill a and surrounding retina becomes uncl ear. But in contrast to the
acu te phase, the amo unt of bleeding and ex udation is smaller, and the degr ee of venou s engorge­
men t is less .

5. papilledema (acute phase)


Generally occ urs as a result of increased intracr anial pre ssure . Th e papill a swells and protru des
into the vit reo us bo dy. Th e ap ical indentation (excavatio papill ae) disapp ears. The boundary
between the pap illa and the surrounding retin a becomes unclear, and the retinal veins become
engorged . Sp linter hemorrh ages appear in the ret ina. .e-
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6. glaucomatous optic atrophy
glau co matou s optic disc cupping and nerv e fibe r bundl e defec l.
Glaucoma causes optic nerv e atrophy. The indentation of the optic papilla (excavatio papill ae)
becom e pale and enlarges, and the d iameter of it becomes over 60% of the total diameter of the
papilla. (cup/disc ratio: CID>0.6) The color o f the marg in o f papilla is norm al, and the bo rder
between the pap illa and the surro unding retina is distinct. Wh en the papill ary indentation stands
out in this w ay, g laucoma sho uld be suspect ed even with out any oth er symptoms. Nerve fiber
bundle detect app ears in a radi atin g patt ern from the pap illa.

7. retinal vein occlusion (acute phase)


na me-shaped hemorrhag es and cotton wool spots.

Caused by venous occlusion at the venous/arterial crossings where ve ins are pressed by sclerotic

a rteries. Flame shaped hemorrhage s run a long the surfac e of retinal ve ins, and soft wh ite spots

(cott on wo ol spots) appear. In areas without hemorrhages , cros sing phenomena by arterios cle ro­

sis can be observ ed .

8. retinal vein occlusion (after retinal laser photocoagulation)


Thc scar from retinal lase r photocoagul ation treatment can be seen as a series or wh itish spots.
A fter bleeding, the retinal ve ins form wh ite line s.

9. toxoplasmosis
rctin och oroiditi. .

Caused by Toxop lasma go nd ii, the mo st or cases are inap parent infection. There are congenital

case s and acquired cas es, of whi ch the present example is the lattcr. TIle lesion usu ally app ears

at posterior area of the retina, and ca uses locali zed exudative retinochoroiditis. In thi s case ,

white and gray lum p can be seen at the macu la.

10. age-related macular degeneration _


macul ar exudate s and subretina l hemorrhage.
The ex udat ive and hemorrhagi c chang es of the macula whi ch are seen mo stly in pat ients ove r
age 60. In the present case, the whi te area of exudates and the red area or hemorrhage are seen at
the macula. Severe leve l of visual impairme nt occ urs aft er repeated hem orrhage from newl y
formed blood vessels.The color o f the fundus is brown or orange. A slightly dark spot in the
m idd le is the macula. At the por tion 15 degrees nasally from the ce nter on the hor izon tal axis ,

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