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Chronic Visual Loss by

SAMIR AL-MANSOURI, MD. Chronic Visual Loss by. Chronic = slowly progressive visual loss. e.g. - cataract - glaucoma - macular degeneration - diabetic retinopathy. Major causes:. One should recognize the normal 1 st to be able to identify the abnormal.

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Chronic Visual Loss by

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  1. SAMIR AL-MANSOURI, MD Chronic Visual Lossby

  2. Chronic = slowly progressive visual loss e.g. - cataract - glaucoma - macular degeneration - diabetic retinopathy Major causes:

  3. One should recognize the normal 1st to be able to identify the abnormal. e.g.  Normal macula  Lens clarity  Optic nerve head  Normal retina etc.

  4. Cataract

  5. Glaucoma - Definition NB a) If detected early and treated, blindness can be prevented. b) Most patients in early glaucoma are asymptomatic.

  6. Investigation: IOP V.F. Exam ONH Gonioscopy

  7. Basic information IOP Aqueous humor circulation Open-angle glaucoma Acute angle-closure glaucoma  symptoms

  8. Basic information Optic nerve Optic disc physiological Cupping pathological

  9. Q: What happens when IOP ?

  10. Examination Q: When? Every 2  4 y past age 40. Particular attention when family history +ve. Q: How? Tonometry / cup: disc ratio

  11. Should be referred for management if: 1. IOP over 21 mmHg. 2. C/D ratio 0.5 or greater. 3. One cup significantly larger in one eye.

  12. Age-Related Macular Degeneration Outer retinal layer Retinal pigment epithelium Bruch’s membrane & choriocapillaris Changes in the macular affect

  13. Drusen deposition Degenerative changes & subretinalneovascular membranes. Pathological changes include:

  14. Visual acuity Amsler grid testing Ophthalmoscopy Others Fluorescein angiography Indocyanine green dye OCT (Optical Coherence Tomography) Examination & Tests

  15. Amsler Grid Testing

  16.  visual acuity Metamorphosia or distortion of vision. Scotoma or blind spot Symptoms include:

  17. Laser treatment of neovascular membrane Low-vision aids Management:

  18. Diabetic Retinopathy

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