Uploaded byAhmed Osama Hashem
Gradual Visual loss.pptx
This document discusses the gradual causes of visual loss, including both reversible and irreversible causes. Reversible causes include cataract, refractive error, corneal disease, diabetic macular edema, age-related macular degeneration, and uveitis. Irreversible causes include optic atrophy, multiple sclerosis, end-stage glaucoma, and retinitis pigmentosa. A thorough history and clinical examination focusing on visual acuity, pupil testing, red reflex, fundoscopy, and visual field testing is needed to diagnose the cause. Appropriate management can reverse some conditions, while others may become permanent if not treated.
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Gradual Visual loss.pptx
- 1. Gradual Causes ofVisual Loss Ahmed Osama Hashem FRCS ophth PHD,Msc Ain Shams University Lecturer , consultant of ophthalmology KFS
- 2. Causes according toprognosis • Reversible causes • Cataract • Refractive error • Corneal disease • Diabetic macular oedema,Hypertensive retinopathy • Age-related macular degeneration • Uveitis • Irreversible causes • Optic atrophy,, MS • Glaucoma- End stage • Irreversible retinal disease ,,Retinitis pigmentosa
- 3. History • Age Young(error of refraction) –Middle age MS -Old(Senile Cataract) • A history of the type of visual loss, e.g. central or peripheral. -Central loss is found with lesions of the macula - peripheral loss is found in glaucoma. • Patients with myopia and certain retinal degeneration may experience poor vision with dim light, and those with a cataract may find bright light to affect the vision more, although this symptom depends on the morphology of the lens opacity.
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- 5. Pin hole ,,,,same idea
- 6. Pupil size andeffect on Vision.
- 7. Cataract,,,History - locationof opacity (Nodal point)
- 8. Central visual fieldloss,,,History
- 9. Peripheral loss ofvisual field
- 10. Lesion in visualpathway,,corresponding VF loss…
- 11. Past history • Medicalhistory -DM ,Ht,RA,SLE,Endocrinal disease(thyroid,pitutary),Neuro(Tumour,MS) -Medication (eye drops)-Systemic drug TB ttt -previous surgery. i.e glaucoma surgery -family history. RP,Glaucoma
- 12. Causes according toprognosis • Reversible causes • Cataract • Refractive error • Corneal disease • Diabetic macular edema • Age-related macular degeneration • Uveitis • Irreversible causes • Optic atrophy,, MS • Glaucoma- End stage,, Drug toxicity • Irreversible retinal disease ,,Retinitis pigmentosa
- 13. Reversible became irreversible •Many of the conditions discussed will initially cause reversible visual loss, but a few may become permanent if they are not appropriately managed. i,e Age related macular degeneration…
- 14. Examination (Clinical) • Theexamination should focus on : • visual acuity, •pupil testing for the presence of an afferent pupil defect, and assessment of the red reflex and fundoscopy. • visual field testing, • IOP, Slit lamp ,Fundus(Direct,Indirect)
- 16. Pupil (very important) Testpupil No Pupillary defect -pin hole Refractive error (myopia- hypermetropic ) -Red Reflex (Media opacity) Corneal opacity- lens opacity -Dilated fundus examination Retinal lesion(DM,ARMD) Pupillary defect A-Neurological lesion (tumor-MS) B-Severe Ocular pathology -Severe retinal disease i.E RP Advanced -Glaucoma, End stage
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- 24. Glaucoma i,e Chronic simpleglaucoma….
- 25. Slit lamp +Gonio lens
- 27. Slit lamp +applanation tonometry
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- 36. Visual field byprojection
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- 41. Not refractive error?!!! • What should we do next?
- 42. By torch ,,dilate the patient ,, observe Red Reflex
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- 73. Anti Vascular EndothelialGrowth Factor
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- 75. 6-Complication of certainDiseases: I,E Uveitis (Intraocular inflammation)
- 77. What is themost probable diagnosis? Mention lines of treatment?
- 78. What is yourdiagnosis ? Mention the ttt briefly ?
- 79. What you cansee at the bottom of the cornea ? What is the treatment ?
- 80. Mention 3 abnormalfindings ? Mention the most common cause?
- 83.