Retinal breaks responsible for RD are caused by
Dynamic vitreoretinal traction
Predisposing degeneration in peripheral retina
Increased in patients who:
Have undergone cataract surgery
Severe eye trauma
SIGN AND SYMPTOMS
Photopsia (sparks or flashes)- Caused by traction on the retina at sites
of vitreoretinal adhesions
Visual field defect ~ dark curtain, cloudy
Fall in acuity ~ detached macula
Vision loss maybe filmy, cloudy, irregular or curtain-like.
One large floater in the middle of the field of vision or a wavy
distortion of objects.
Marcus Gunn pupil (relative afferent pupillary defect)
Grey opalescent retina, balloning forward.
Extensive detachment of the retina will pull of the macular.
The billowy, gray spinnaker-like folds represent the
detached retina—the part that has become elevated from its
attachment to the underlying retinal pigment epithelium.
Retinal Reattachment surgery
Sealing of retinal breaks
By cryocoagulation, photocoagulation or diathermy
(to create an adhesion between the pigment epithelium and the
Allow immediate apposition between sensory retina and RPE
By using fine needle
Maintain chorioretinal apposition
An inflammatory & demyelinating disorder affecting
the optic nerve.
It can be classified opthalmoscopically and
Demylinating – common cause
Parainfectious – follow a viral
Infectious – may be sinus-
related or a/w cat scratch fever,
Lyme ds, cryptococcol
meningitis in pt wt AIDS&
Retrobulbar neuritis –
Papillitis: inflam & demyelinating
optic disc- Hyperamia & oedema
Neuroretinitis – optic disc &
surrounding retina in macular
What is the most common cause for the
Multiple sclerosis. Long term studies
indicated that up to 75% of female patient
initially developed optic neuritis
ultimately developed MS.
Visual loss – Sudden, progressive,profound
(progressively blurrier over a period of hours or days)
Blurred vision in bright light – typical
Pain behind the eyes
esp in retrobulbar neuritis
aggravated by ocular movement (esp:downward&upward)
Loss/reduce of color vision
Preceding history of
Reduced visual acuity
Impaired color vision
Visual field changes - Central scotoma
Swinging flash test – affected pupil will dilate when
flash light is moved from normal to abnormal eye
(Marcus gunn pupil)
Papillitis- hyperaemia of disc & blurring margin
Disc- edematous& obliterating cup, splinter hrrge,
Retinal veins tortous and congested
Treat the underlying cause- cardiovascular or
Treatment: steroid to reduce the inflammation and
35 year-old woman presented with unilateral worsening
of vision of left eye, accompany by discomfort of eye
movement for two weeks duration
Visual acuity of left eye is 6/60.
Impaired color vision.
There is left afferent pupillary defect and a central
Funduscopy reveals the above image.
What is the likely diagnosis
A. Optic Nerve Glioma
B. Cavernosus Sinus thrombosis
C. Grave’s disease
D. Pituitary Adenoma
E. Optic Neuritis