Dr Clairton De Souza Dr Richard Hart Dr Sonya Bennett Senior - - PowerPoint PPT Presentation
Dr Clairton De Souza Dr Richard Hart Dr Sonya Bennett Senior Lecturer, Optometry Ophthalmologist, Cataract Surgeon Consultant Ophthalmologist Clinical Senior Lecturer in Ophthalmology Ophthalmic Plastic Surgeon Greenlane Clinical Centre Eye
Dr Richard Hart
Ophthalmologist, Cataract Surgeon Ophthalmic Plastic Surgeon Auckland
8:30 - 9:25 WS #213: Glaucoma, Retinal Disease and the Watery Eye 9:35 - 10:30 WS #225: Glaucoma, Retinal Disease and the Watery Eye (Repeated)
Dr Sonya Bennett
Consultant Ophthalmologist Greenlane Clinical Centre Eye Clinic
Dr Clairton De Souza
Senior Lecturer, Optometry Clinical Senior Lecturer in Ophthalmology University of Auckland
Dr Clairton F. de Souza
Major retinal disorder requiring surgery
New Zealand (Polkinghorne and Craig 2004) Major cause of severe loss of vision Success rate of primary surgical repair: 85%; (95% after 2-3 surgeries)
Idiopathic Polypoidal Choroidal Vasculopathy
Retinal Detachment – Macula-on
Vision: 6/24 Vision: 6/9
Retinal Detachment
Loss of central vision
Detached Retina Attached Retina
Fovea
Normal Vision:
6/6 Vision in RRD: Counting fingers Vision after RRD repair: 6/15
Retinal Cell Biology Lab – Institute of Neuroscience, Santa Barbara California
Iridodialysi s Lens subluxation
Does Bungee jumping cause retinal detachment?
jumping and retinal detachment
Gravitational force (G-force) Rapid - 3G deceleration Intravenous pressure: +100mmHg
All papers report: Ocular haemorrhages (conjunctival and retinal)
Valsalva Phenomenon
Does Bungee jumping cause retinal detachment?
jumping and retinal detachment
Gravitational force (G-force) Rapid - 3G deceleration Intravenous pressure: +100mmHg
All papers report: Ocular haemorrhages (conjunctival and retinal)
Valsalva Phenomenon
Is it preferable for a high myope pregnant to give birth by C-section? No.
High myopes and even women with history
Valsalva manœuvres during labour do not increase risk of retinal detachment Hormonal and Immunological changes during pregnancy do not increase risk of retinal tear/detachment in high myopic women. Is she at higher risk of retinal detachment after normal labour?
Importance of Awareness of retinal detachment symptoms
Floaters – Ophthalmologist view
Flashes (Photopsia) - Differential Diagnoses
Diagnosis Duration Colour Location Shape Stimulus Other symptoms Flickering PVD Seconds
White Temporal Periphery Crescentic vertical Eye Movements Floaters No Migraine 20-30 minutes Not typical Paracentral Arcuate, zigzag Stress, food Scotoma, headache, nausea Yes Occipital ischaemia Minutes Nil Central Petaloid Neck movements, exertion Yes Cystoid Macular Oedema Constant Variable Central Pinpricks Nil Poor vision Yes Outer retinal
abnormality Minutes Blue/purple Paracentral Blob, spirals Nil Scotoma No Retinal detachment Seconds Golden Central/par acentral Comet
horizontal Eye Movements Visual field loss No
surgery for non-complex cases (95% with 2 or more surgeries).
symptoms and prompt referral are crucial for optimal visual prognosis.
Diagnosis Duration Colour Location Shape Stimulus Other symptoms Flickering PVD Seconds
White Temporal Periphery Crescenti c vertical Eye Movements Floaters No Migraine 20-30 minutes Not typical Paracentral Arcuate, zigzag Stress, food Scotoma, headache, nausea Yes Occipital ischaemia Minutes Nil Central Petaloid Neck movements, exertion Yes Cystoid Macular Oedema Constant Variable Central Pinpricks Nil Poor vision Yes Outer retinal
abnormality Minutes Blue/purple Paracentral Blob, spirals Nil Scotoma No Retinal detachment Seconds Golden Central/par acentral Comet
horizontal Eye Movements Visual field loss No
Flashes (Photopsia) - Differential Diagnoses