1 / 87

None-urgent eye problems David Kinshuck, associate specialist David Kinshuck, Good Hope Hospital,

None-urgent eye problems David Kinshuck, associate specialist David Kinshuck, Good Hope Hospital, . None-urgent eye problems …working in pairs, (1 minute) write down. Common conditions Rarer & serious conditions. Draw an eye and name the parts…working in pairs, (30 s) :. parts

zoltan
Download Presentation

None-urgent eye problems David Kinshuck, associate specialist David Kinshuck, Good Hope Hospital,

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. None-urgent eye problemsDavid Kinshuck, associate specialistDavid Kinshuck, Good Hope Hospital,

  2. None-urgent eye problems…working in pairs, (1 minute) write down • Common conditions • Rarer & serious conditions

  3. Draw an eye and name the parts…working in pairs, (30 s) : • parts • Parts relevant to conditions

  4. www.websightmd.com

  5. www.websightmd.com Aqueous flow

  6. Chronic eye conditions • Adults • cataracts • Armd...age-related macular degeneration • Glaucoma • Diabetic retinopathy • Others (retinal vein occlusion, inherited retina, corneal etc) • children • Squints • Watery eye • Cataracts • Glaucoma • rarer

  7. Cataracts Symptoms How to examine Operation refraction

  8. Cataracts symptoms, in pairs • ? • ? • ? • ?

  9. Cataracts symptoms Glare Misty vision Blurred vision Cannot see distances/faces

  10. Cataracts...symptoms....blurred

  11. Cataracts...symptoms....glare

  12. Examining for cataract…red reflex Looking through ophthalmoscope, check red reflex from 10 cm, focusing on iris rim

  13. www.occhioallaretina.it/Immagini/leucocoria.JPG http://oftalmologo.bravepages.com/Leucocoria%201.jpg ‘white’ reflex ?retinoblastoma

  14. Cataracts...operation Link • http://www.goodhopeeyeclinic.org.uk/eyecataractpatient.html

  15. Cataracts...refraction...in pairs, which is myopia etc

  16. Cataracts...refraction • Emmetropia..no dist. specs • Hypermetropia, small eyes • Myopia • High myopia

  17. Presbyopia...need reading spectacles, >45y

  18. Retina • Diabetic retinopathy • Retinal vein occlusion • Armd...age-related macular degeneration • Others • retinal vein occlusion • inherited retina (eg retinal pigmentosa)

  19. Diabetic retinopathy, in pairs, 45 seconds • What are the disease processes • What one chemical in particular mediates these processes (and we can block its effect) • What does laser do http://medweb.bham.ac.uk/easdec/dmret.html http://medweb.bham.ac.uk/easdec/mechanismanimation.htm

  20. Diabetic retinopathy

  21. Diabetic retinopathy • dot and blot • ischaemic areas • VEGF • leakage • new vessels

  22. Diabetic retinopathy • dot and blot • ischaemic areas • VEGF • leakage • new vessels

  23. Diabetic retinopathy

  24. Diabetic retinopathy

  25. Diabetic retinopathy http://reference.medscape.com/features/slideshow/retina

  26. Diabetic retinopathy, in pairs, how do you prevent, 30s

  27. Diabetic retinopathy, in pairs, how do you prevent, 30s • Prevent diabetes…exercise, weight, low glycaemic index foods • Screen for diabetes…everyone >40y, high risk if lower (lifestyle/family etc), • HbA1c >6.5% = diabetes • HbA1c 6.0-6.5% = pre-diabetes • Control diabetes HbA1c <6.5-75, BP <130/80, statin, ARB • Screen diabetic patients for retinopathy • etc

  28. Diabetic retinopathy • HbA1c • Blood pressure • Smoking • Lipids • Duration of ‘high’ HbA1c • similar for BP/smoking/lipids

  29. Retinal vein occlusion 7 highs • cigarettes • Cholesterol • Blood pressure • Glucose • Viscosity • Myeloma • White cells

  30. Macula..in pairs, 1 minute • What do you know about armd • Symptoms • Types • etc

  31. Macular Central visual changes suggest macula disease: Eye casualty same week

  32. Central vision

  33. OCT optical coherence tomogram … wet ARMD http://www.goodhopeeyeclinic.org.uk/images/lucentis.html

  34. Dry, ‘geographic atrophy’ Areas of atrophy enlarge over a couple of years, seriously reducing central vision

  35. Glaucoma, in pairs, explain with diagram, 1 min

  36. Glaucoma, mechanism • Aqueous produced in ciliary body (carbonic anhydrase enzyme) • Flows into >anterior chamber, >through trabecular >meshwork, >canal of schlemm, >episcleral veins • > otherwise pressure

  37. Glaucoma, loss of visual field • Visual loss over years • 2/3 chronic glaucoma has a high pressure…pressure is detected by whom • A patient • B optometrist

  38. Glaucoma, loss of visual field • Visual loss over years • 2/3 chronic glaucoma has a high pressure…pressure is detected by whom • A patient • B optometrist

  39. Glaucoma, in pairs, which normal eye, 30s A B http://www.goodhopeeyeclinic.org.uk/glaucomacase3.htm

  40. Glaucoma, in pairs, which normal eye, 30s • Vessels deviated nasally • Pale central area with cribriform pits • thin rim • Other minor changes http://www.goodhopeeyeclinic.org.uk/glaucomacase3.htm

  41. Glaucoma, lowering pressure • Laser trabecular meshwork • Drops • Prostaglandin inhibitors • Carbonic anhydrase inhibitor • Betablockers • tablets • Carbonic anhydraseinhibitor • surgery

  42. Glaucoma, quiz • Patient detects glaucoma Y N

  43. Glaucoma, quiz • Are there symptoms early Y N

  44. Glaucoma, quiz • Examining the eye • Cupped disc Y N

  45. Glaucoma, quiz • Examining the eye • Raised pressure 66% Y N

  46. Glaucoma, quiz • Examine angle at onset Y N

  47. Glaucoma, quiz • Visual field Y N

More Related