The back of the eye'

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The back of the eye.

• Some fundoscopy images.

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Fundoscopy

• 1. Some rare things.
• 2. Some common things.
• 3. Some more rare things related to a case I saw.

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Coats Disease.

• AKA exudative retinitis
• Abnormal development bloods vessels behind retina
• Usually one eye is affected
• Young males 18mt 18years
• Blood leaks from abnormal vessels causing oedema
  and cholesterol deposits
• Can lead to retinal detachment, glaucoma and
  cataracts.

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Symptoms of Coats Disease.

• Flashers and floaters
• Upper visual field disturbances corresponding to
  blood pooling in bottom of eye
• Yellow eye in flash photography due to
  cholesterol deposits
• Treated by lasering abnormal blood vessels.

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Retinoblastoma

• 1 in 25,000
• Children lt5
• 10 hereditary, rest sporadic
• White pupil cats eye (leucocoria)
• Concomitant squint, posterior uveitis
• No red reflex, flash photography white eye
• Enucleation or laser therapy. 80 survival if
  unilat but 40 if bilateral.

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NICE Referral

• New seizures
• Cranial nerve abnormalities
• Visual disturbances
• Gait abnormalities
• Motor sensory signs
• Unexplained deterioration in school performance
• Unexplained behavioural / mood change
• lt2, abnormal eye movements, lack of following,
  squint

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Faces of retinoblastoma
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Some disc things.
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Glaucoma.
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Normal.
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Optic neuritis.

• MS
• Herpes zoster
• Autoimmune disorders
• Chloramphenicol
• Vasculitis
• ethambutol

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Optic Neuritis

• Dec. Acuity over hours or days
• Red appears less red
• Eye movemnts hurt
• Afferent defect
• Disc can look normal
• Returns to normal 8-10 weeks
• Can advance to complete visual loss
• Treated with steroids

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Papilloedema

• Disc margins are blurred as with neuritis
• Raised ICP
• Malignant hypertension
• Cavernous sinus thrombosis

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Images related to a case I saw.
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Retinitis Pigmentosa

• Inherited
• Progressive peripheral visual loss
• Night vision probs.
• 15000
• 30s-50s
• Associated with v.rare eponymous syndromes Kearn
  Sayre syndrome Ushers syndrome
• No treatment
• Monitor for development cataracts, retinal
  swelling

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Choroidal nevus

• Freckle in the eye
• 5 incidence
• Need to be monitored looking for evidence of
  change

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Choroidal melanoma

• Lesion 3-4 times diameter of disc or 5mm thick
  and 2mm thick.
• Most develop from pre-existing nevi
• 6/1,000,000
• Asymptomatic for long time
• Blurred visual acuity
• Paracentral scotomas
• Painless visual loss
• Met. distally

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APPLAUSE.

• (please)