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Retina
Examination&investigation
Dr_Mohamed ELShafie, assistant lecturer
Anatomy
• It is the senstive and inner most layer of the
eye
• Derived from neural ectoderm
• Extend from optic disc centrally to ora serrata
peripherally……..
Minute anatomy
Histologically
formed of ten
layers
1. The pigment epithelium
2. The rods and cones
3. The external limiting membrane
4. The outer nuclear layer
5. The outer plexiform layer
6. The inner nuclear layer
7. The inner plexiform layer
8. The ganglion cells
9. The nerve fiber layer
10.The internal limiting membrane
Blood Supply of the Retina
(1) The outer laminae, including the rods and
cones and outer nuclear layer, are supplied
by the choroidal capillaries
(2) The inner laminae are supplied by the central artery and vein.
central retinal vein ….drain into cavernous sinus
Fundus examunation
Direct ophthalmoscope
• Uniocular
• No stereopsis
• Erect image
• high magnification ×15
• small field
Indirect ophthalmoscope
• Binocular vision
• Stereopsis
• Inverted image
• Low magnification ×5
• Large field
Slit lamp biomicroscopically
With contact lens
Goldman 3 mirror lens
With non contact lens
• Biconcave(Hruby lens)
• Biconvex lens (+60&+78&+90)
Appearane of normal fundus
How to test the center of the retina =
macula = macular function tests
• Form sense: VA
• Colour sense:
Clear media: ishihara colour book
Opaque media:
Ophthalmoscope
coloured filters + light source
Some investigations
 OCT
Flourescein angiography
Visual field examination
Conferentation
test
• Compares peripheral vision with a tester who
has normal peripheral vision
• 2 ft. apart, eye level
• Tester & client cover opposite eyes
• Tester advances finger in the periphery
– Superiorly ( 50 degrees )
– Inferiorly ( 70 degrees )
– Temporally ( 90 degrees )
– Nasally ( 60 degrees )
3_Perimetery
Visual field defect
• scotoma
blind spot is physiological -ve scotoma
• Hemianopia
involve one half of field(heterogenous& homonymous)
Fundus picture of some diseases
• Diabetic Retinopathy
•
VEDIO
PRP
Hypertensive Retinopathy
CRAO&CRVO
BRAO&BRVO
Embolization is the most common cause of obstruction to the retinal
circulation, e.g. an embolus from a vegetation on one of the valves of
the heart in cases of subacute bacterial endocarditis
Degenerative changes within the arterial wall, e.g.
arteriosclerosis or atherosclerosis.
Rhegmatogenous RD
Tractional RD
Retinitis pigmentosa
34
Retinoblastoma.
35
RETINOPATHY OF PREMATURITY
papilloedema
1ry optic atrophy
Glaucomatous optic atrophy
retina-161224144309.pdf

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retina-161224144309.pdf