Areolar Dystrophy
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A 31-year-old Vietnamese male presented with gradual decreased vision in both eyes since adolescence. Examination revealed pigment epithelial atrophy in the foveal area of both eyes. Fluorescein angiography showed window defects from absent choriocapillaries in the macula of both eyes. He was diagnosed with central areolar choroidal dystrophy, a rare autosomal dominant condition characterized by atrophy of the neuroepithelium, pigment epithelium, and part of the choroid resulting in gradual visual loss.
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Central serous chorioretinopathy (CSCR) is a disease characterized by a serous detachment of the neurosensory retina over an area of leakage from the choriocapillaris through the retinal pigment epithelium. It commonly affects middle-aged men and presents with blurred vision, metamorphopsia, and micropsia. Imaging such as optical coherence tomography and fluorescein angiography can help diagnose focal leaks at the level of the RPE. While the condition typically resolves spontaneously, recurrence is common and chronic cases can lead to permanent vision loss. Treatment may include carbonic anhydrase inhibitors or laser photocoagulation for persistent or recurrent cases.
Coats Disease
This document summarizes a presentation on Coats' disease in a 16-year-old male patient. Key details include fundus photos and angiogram images showing lipid-rich subretinal exudates in the posterior pole of the left eye. Coats' disease is described as an idiopathic condition characterized by telangiectatic and aneurysmal retinal blood vessels leading to intraretinal and subretinal exudation. Clinical features, pathogenesis, differential diagnosis, diagnostic testing, and treatment approaches are briefly outlined.
Retina Rounds
Torpedo maculopathy was diagnosed in a young patient based on the characteristic appearance and location of the lesion. Multiple bilateral lesions were discovered in a child that were suggestive of familial adenomatous polyposis. Recurrent branch retinal artery occlusions in a young patient led to the diagnosis of Susac's syndrome based on the clinical triad of neurological symptoms, hearing loss, and retinal vascular occlusions.
Bests' disease case report
This case report describes a 13-year-old male patient diagnosed with Best's vitelliform macular dystrophy, an autosomal dominant disorder characterized by a yellow yolk-like lesion in the macula. The patient presented with gradual reduction of vision and blind spots in both eyes. Examination revealed bilateral macular atrophy and metamorphopsia. Electrooculography was not performed due to lack of facilities. The patient's vision remained stable over one year, and his parents had normal exams. Best's disease involves accumulation of lipofuscin in retinal pigment epithelial cells and progresses through stages from normal to atrophic vision loss. There is no treatment to slow progression.
Ophthalmology sheet
This document provides guidance on performing a thorough history and examination of the eye. It emphasizes the importance of taking a comprehensive patient history to help guide the examination and identify any needed tests. The history should include personal details, chief complaints, past ocular and medical history, medications, family history, and social factors. Examination involves assessing visual acuity, adnexa, anterior segment using a slit lamp, and the posterior segment through ophthalmoscopy. Performing a structured history and detailed examination is key to making an accurate diagnosis.
approach to congenital cataract.pptx
This document discusses lens anatomy and development, as well as congenital cataracts. It notes that the lens develops from surface ectoderm, not neuroectoderm, and that crystallins make up 90% of lens proteins. Congenital cataracts can be classified based on morphology, laterality, progression, and genetic or syndromic associations. Evaluation of a congenital cataract case includes family history, examination of acuity and ocular structures, laboratory tests, and potentially genetic testing. Treatment involves surgery, with timing depending on density and progression of the cataract.
An approach to congenital cataract genetic based
This document discusses lens anatomy and development, as well as congenital cataracts. It notes that the lens develops from surface ectoderm, not neuroectoderm, and that crystallins make up 90% of lens proteins. Congenital cataracts can be classified based on morphology, laterality, progression, and genetic or syndromic associations. Evaluation of a congenital cataract case includes family history, examination of acuity and ocular structures, laboratory tests, and potentially genetic testing. Treatment involves surgery, with timing depending on density and progression of the cataract.
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Posterior uveitis of unknown cause white spot syndromes
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Case Report and Clinical Findings of Central Serous Retinopathy
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An Unusual Case of Posterior Ischemic Optic Neuropathy
Doheny Grand Rounds Case Study by Dr. Patty Lauren. An Unusual Case of Posterior Ischemic Optic Neuropathy.
Neurosarcoidosis
This document presents a case of a 48-year-old African American female who presented with sudden decreased vision in her right eye over 5 days. Examination revealed signs of optic neuropathy in the right eye including decreased vision, color plate errors, and disc edema. Imaging and biopsy results showed enlarged lymph nodes and noncaseating granulomas consistent with sarcoidosis. Sarcoidosis can cause ocular involvement including uveitis, conjunctival granulomas, and optic neuropathy through infiltration or compression of the optic nerve. Treatment involves corticosteroids and immunosuppressants to manage systemic disease.
Color Vision Testing
The document discusses color vision testing techniques and color deficiencies. It describes various color vision tests including pseudoisochromatic plates, lantern tests, arrangement tests, and anomaloscopes. It explains what each test screens for and its purpose. It also discusses the different types of color deficiencies including red, green, blue deficiencies and how color may appear to those with deficiencies.
Asoct Tube Postion
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SCH
- 86 year old patient presented with headache and severe eye pain 9 days after complete blindness in one eye following ocular surgery
- Exam found corneal edema, shallow anterior chamber, and no view of fundus in the affected eye
- Ultrasound showed suprachoroidal hemorrhage, and the plan was for retina service to consult and revise the shunt and scleral graft with drainage of the hemorrhage.
PalmScan x IOL Master
This study compared axial length measurements from the PalmScan immersion ultrasound and the IOL Master in 74 eyes. The average difference in axial length measurements between the two devices was 0.022 mm, with a standard deviation of 0.1 mm. The correlation coefficient between the two measurement techniques was 0.998. In 4.1% of eyes, the PalmScan was needed to obtain an axial length measurement when the IOL Master could not get a measurement. The study concluded that the PalmScan provides comparable axial length measurements to the IOL Master and can be used when the IOL Master cannot obtain a measurement.
Vector-Adjusted NAPA Limbal Relaxing Incisions at the Time of Cataract Surgery
1) The document presents a study on the effectiveness of using limbal relaxing incisions (LRIs) at the time of cataract surgery, with adjustments to the depth and axis of the incisions based on peripheral corneal thickness measurements.
2) 28 patients undergoing cataract surgery with over 0.5 diopters of astigmatism received LRIs, with the depth and axis determined using a vector-adjusted nomogram based on pachymetry readings.
3) Results found that 96% of patients achieved good visual acuity outcomes, with most having 0.5 diopters or less of residual astigmatism after surgery. One patient required enhancement for residual cylinder. No serious complications occurred.
Conjunctival MALT Lymphoma
A 24-year-old man presented with an enlarging growth in his right eye that had been progressively growing larger over 8 months since being kicked in the eye. Examination found a growth in the right eye with full vision and eye movement. Biopsy of the growth found characteristics of mucosa-associated lymphoid tissue (MALT) lymphoma. MALT lymphoma can occur in the conjunctiva and has a generally favorable prognosis when treated locally. Further testing will be done to evaluate if the cancer is localized or has spread systemically.
Stevens-Johnson Syndrome
A 45-year-old African American woman presented with a two day history of sore throat, eye pain and redness, fever, and malaise. On examination, she had visual acuity of 20/40 in both eyes, round and reactive pupils, and erythema of the eyelids and conjunctiva. The presentation is consistent with erythema multiforme, a spectrum of mucocutaneous disorders that can be drug-induced or due to infection. Management involves supportive care, steroids, immunoglobulins, and addressing both acute ocular involvement and long-term complications.
PDT VHL
This document discusses the case of a 57-year-old female patient with von Hippel-Lindau (VHL) disease who presented with decreased vision in her left eye due to retinal hemangioblastoma. She underwent two unsuccessful laser treatments but photodynamic therapy (PDT) resulted in significant resolution of the serous retinal detachment and cystoid macular edema. PDT was concluded to be an effective treatment for exudative retinal detachment caused by retinal hemangioblastomas in patients with VHL disease.
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Areolar Dystrophy
- 1. Doheny Eye Institute Grand Rounds Presenter Irina Bykhovskaya, MD Discussant SriniVas Sadda, MD 4/20/2007
- 4. Fundus Photos Horizontal oval, slightly areolar zone of pigment epithelial atrophy in foveal area OU
- 5. Red Free Fundus Photos
- 6. Fluorescent Angiogram Window defects reveal absent choriocapillaries in the macula OU Hyperfluorescence at the lesion margins from dye leakage from intact choriocapillaries
- 9. Copyright restrictions may apply. Keilhauer, C. N. et al. Arch Ophthalmol 2006;124:1020-1027. Clinical Findings