Clinical Presentation of Vitreoretinal

Disorders

Dr. Ayesha Abdullah30.1.2015

Learning outcomes

By the end of this lecture the students would be able to;• Identify the common symptoms and signs of VR

disorders (VRD) and correlate them with the underlying problems with the structure and function of the VR.

• Identify structural landmarks on retinal photographs.• Correlate the indications for commonly used

investigations for the assessment of retinal disorders with the underlying pathology.

Some questions

• How do we see?• What are the similarities and differences between a camera

and the eye?• Name part of the nervous system that can be visualized

without any invasive procedure • Why is the optic disc referred to as the blind spot?• Have you noticed tiny bright moving dots when looking into

the blue sky?• Why are the photoreceptor placed posteriorly while the

light enters the retina anteriorly?• How do we know its day/ night?

Camera and the eye

• Unlike the image from a camera the resolution of the retinal image is not uniform.

• Why?• There are about 100 times more photoreceptors than the Ganglion cells.• Why?• Retina compresses images as unlike the camera.

Anatomical landmarks of the retina

• What is the size of the normal optic disc?• Size of the Macula?• Size of fovea• Thinnest part of the retina?• Thickest part?

Common Presenting Symptoms in VRD

• Visual loss, mostly painless, sudden/ gradual • Loss of central vision• Loss of peripheral vision• Loss of visual field • Loss of colour vision• Distorted vision; metamorphopsia, micropsia,

macropsia

Common Presenting Symptoms in VRD

• Loss of contrast sensitivity • Glare sensitivity • Night blindness• Photopsia/ flashes • Floaters ; 'specks', 'flies', 'spiders' and,

‘cobweb‘, ‘mosquitoes’.

Loss of central vision

http://www.retina-international.org/

Loss of peripheral vision

http://www.retina-international.org/

Contrast sensitivity and light & dark adaptation problems

Contrast sensitivity and light & dark adaptation problems

Glare

Flashes of light/ photopsia

Floaters

Colour vision deficiency

http://www.achromatopsia.info/childrens-vision/

Field loss

Scotoma Negative Scotoma Positive Scotoma

Swollen optic disc

Pale optic disc

Macular signs

Retinal Haemorrhages

Vascular changes

Exudates

Cotton wool spots

Retinal Tear/ hole

New Vessels

?RAPD

Quiz

Commonly used investigations

B Scan

A Scan

OCT

Angiography

Electroretinogram

7- Functions of Retina

msqheartline@hotmail.comLast date for submission 15th February 2015