Term
| 3 contraindications to scleral indentation |
|
Definition
Penetrating Trauma
Recent Surgery
New IOL (less than a month) |
|
|
Term
|
Definition
|
|
Term
| How many short posterior ciliary nerves |
|
Definition
|
|
Term
| How many long posterior ciliary nerves |
|
Definition
|
|
Term
| How can blood vessels be used to confirm the view is ora serrata and not pathology |
|
Definition
| blood vessels start to turn away from the ora, they do not go through it |
|
|
Term
| Which sector of the ora serrata is more notched, nasal or temporal? |
|
Definition
|
|
Term
| One main differential between an oral bay and a retinal hole |
|
Definition
|
|
Term
| Describe cystoid degeneration |
|
Definition
| tiny bubbles next to ora beneath vitreous base, thickened retinal tissue that is slightly opaque |
|
|
Term
| Cystoid degeneration is most commonly found in what portion of the retina |
|
Definition
|
|
Term
| Cystoid Degeneration starts near the _____________ and can reach all the way to the _______________________ but can not be the other way around |
|
Definition
| Cystoid Degeneration starts near the ora serrata and can reach all the way to the equator but can not be the other way around. If it starts at the equator but does not stretch back to the ora it is not cystoid |
|
|
Term
| Cystoid degeneration-creates risk for RD or retinoschisis? |
|
Definition
|
|
Term
| Treatment of Cystoid Degeneration |
|
Definition
| None-just monitor, usually found on the inner portion of the retina thus there is no risk for RD |
|
|
Term
| True or False White without pressure is usually elevated pathology |
|
Definition
|
|
Term
| How does 'white with pressure' affect the appearance of choroidal markings and retinal BV |
|
Definition
Choroidal markings are obscured
Retinal vessels are very obvious |
|
|
Term
| What is the least common portion of the retina for 'white with and without pressure' to occur? |
|
Definition
| Inferior nasal is least common |
|
|
Term
| Approx how common is white with and without pressure? |
|
Definition
|
|
Term
| Pathophysiology of white with and wihtout pressure |
|
Definition
| Vitreous traction on retina |
|
|
Term
| Generally there is no concern associated with 'white with or without pressure' Name 3 situations when further action may be required |
|
Definition
Vitreous Degeneration
Nearby Lattice Degeneration
Hx of large retinal tear in the other eye |
|
|
Term
| Why does paving stone degeneration have a yellow-white appearance |
|
Definition
| It is caused by thinning of the outer layers of the retina which causes more visibility of the sclera |
|
|
Term
| Paving stone degeneration- excavated or elevated? |
|
Definition
| Excavated-it is thinning of the outer retinal layers |
|
|
Term
| Most common place for pavingstone degeneration |
|
Definition
|
|
Term
| Pathophysiology of pavingstone degeneration |
|
Definition
| Infarctions in the choriocapillaris disrupts nutrition to the outer retinal layers |
|
|
Term
| Pavingstone Degeneration-sharp or blurry borders |
|
Definition
|
|
Term
| Which parts of the back of the eye are NOT affected by Pavingstone Degeneration |
|
Definition
| Vitreous and Inner Retina are not affected |
|
|
Term
| Name 4 common differentials between histoplasmosis and pavingstone degeneration |
|
Definition
Edges of histo are less distinct
Histo does not tend to have pigment
Histo spreads around the retina, pavingstone is clumped
Pavingstone in the periphery |
|
|
Term
| Reticular Senile Pigmentary Degeneration-tend to be bilateral or symmetrical? |
|
Definition
|
|
Term
| Pathophysiology of Reticular Senile Pigmentary Degeneration |
|
Definition
| Some RPE cells lose pigment, others have increased pigment, pigment deposits near retinal venules, forms a net-like appearance of pigment |
|
|
Term
| How may Reticular Senile Pigmentary Degeneration be differentiated from Retinitis Pigmentosa |
|
Definition
|
|
Term
| Treatment of Reticular Senile Pigmentary Degeneration |
|
Definition
|
|
Term
| Most common location for vitreoretinal tufts |
|
Definition
| Most commonly nasal, just posterior to ora in vitreous base |
|
|
Term
| What proportion of the population has noncystic vitreoretinal tufts |
|
Definition
|
|
Term
| Pathophysiology of vitreoretinal tufts |
|
Definition
| small masses of cells of degenerated retina or proliferated glial cells |
|
|
Term
| Risks associated with vitreoretinal tufts |
|
Definition
| Firm attachments between retina and vitreous can cause retinal breaks |
|
|
Term
| What other finding must be ruled out when a vitreoretinal tuft is discovered |
|
Definition
| Must make sure there are no holes at the base |
|
|
Term
| For vitreoretinal tufts, photocoagulation or cryopexy is considered when any of these 3 risks are present |
|
Definition
Complains of flashing lights
Pigment in vitreous
RD in fellow eye |
|
|
Term
| Pathophysiology of Meridonial Folds |
|
Definition
| Radially oriented folds of redundant retinal tissue |
|
|
Term
| Location and orientation of meridonial folds |
|
Definition
| Superior nasal, perpendicular to ora |
|
|
Term
| When is a meridonial fold called a meridonial complex |
|
Definition
| Complex if it covers both bay and process |
|
|
Term
| How common are meridonial folds |
|
Definition
|
|
Term
| Meridonial folds are more likely to lead to retinal detachment in what quadrant? |
|
Definition
|
|
Term
| 2 common findings at the end of a meridonial fold |
|
Definition
vitreoretinal tag at end of fold
Retinal hole at posterior end |
|
|
Term
| Retinol holds more common in meridonial folds or meridonial complexes? |
|
Definition
|
|
Term
| F/U for pt with meridonial fold and accompanying hole or tag |
|
Definition
|
|
Term
| Why may lattice have pigmented borders? |
|
Definition
| Vitreous traction causes RPE hyperplasia |
|
|
Term
| Where does lattice degeneration tend to occur? |
|
Definition
| Between periphery and equator in the vertical meridians |
|
|
Term
| If lattice degeneration is found near the equator it tends to be _______________-_(radial or circumferential?) |
|
Definition
|
|
Term
| Describe the vitreous surrounding lattice degeneration |
|
Definition
| Vitreous tents over the lattice with firm attachments on the border, there is vitreous liquefacton above the lesion |
|
|
Term
| 4 findings/risks associated with lattice degeneration |
|
Definition
Vitreous liquefaction
Fine white specks in lesion
RD (esp w radial lattice)
Partial/full thickness hole |
|
|
Term
| White specks can sometimes be found in lattice degeneration, what are these made of? |
|
Definition
| Fragmented pieces of inner retinal layers |
|
|
Term
| How can we differentiate retinal thinning from a retinal hole? |
|
Definition
|
|
Term
| Why do atrophic holes not create much risk for retinal detachment |
|
Definition
| There is generally no flaps or vitreous attachment so there is little risk of it being pulled on and detaching |
|
|
Term
| Retinal Horseshoe Tears have what 2 attachments |
|
Definition
| Piece attached to vitreous and a piece attached to retina |
|
|
Term
| Where does the horse run in horseshoe tears? |
|
Definition
|
|
Term
| Which is more likely to cause RD, horseshoe tear or round hole? |
|
Definition
|
|
Term
| 3 common differences between horseshoe tear and atrophic hole |
|
Definition
| Horseshoe generally larger, different shape (round vs. horseshoe), horseshoe has vitreous attachment, atrophic hole does not |
|
|
Term
| Management of horseshoe tear |
|
Definition
| REFER-must get this fixed before it progresses to a full blown retinal detachment |
|
|
Term
Rate likelyhood of Retinal Detachment between:
Horseshoe tear, atrophic hole, operculated tear |
|
Definition
| Greatest with horseshoe, next is operculated tear, atrophic hole is last |
|
|
Term
| Describe operculated tears |
|
Definition
| Retinal hole with flap of tissue completely torn off |
|
|
Term
| Relate size of operculum with age |
|
Definition
| The smaller the operculum the longer it has been there |
|
|
Term
| Common cause of operculated and horseshoe tear |
|
Definition
|
|
Term
| Which has more risk of RD, partially detached operculum or fully detached operculated hole |
|
Definition
| Less risk once the operculum fully detaches |
|
|
Term
| How may the view of the retina contribute to diagnosis of RD |
|
Definition
| Detachments mask the choroid. When looking at normal retina you can see subtle details/striations of the choroid. The lack of these details can indicate a RD |
|
|
Term
| 2 signs that may indicate a retinal detachment is old |
|
Definition
Pigment demarcation line
Tissue no longer undulates with eye movement, is fibrotic |
|
|
Term
| Differentiate between a rhegmatogenous vs. non-rhegmatogenous retinal detachment |
|
Definition
Rhegmatogenous=secondary to retinal break
Non-rhegmatogenous=secondary to traction or fluid accumulation in subretinal space |
|
|
Term
| Where does fluid accumulate in a retinal detachment |
|
Definition
| Between RPE and sensory retina |
|
|
Term
| Visual defect of RD compared to retinoschisis |
|
Definition
RD= relative scotoma
Retinoschisis=Absolute scotoma |
|
|
Term
| Most common location for retinoschisis |
|
Definition
|
|
Term
| Retinoschisis vs. RD-which is associated with the development of pigment demarcation |
|
Definition
| RD, is not a retinoschisis if pigment deposits |
|
|
Term
| Location of split in a retinoschisis |
|
Definition
| Splitting between inner plexiform and outer nuclear layers |
|
|
Term
| Describe the risk of RD associated with Retinoschisis |
|
Definition
| Low potential for RD since the holes are inner enough that they will not cause fluid to collect b/w RPE and sensory retina |
|
|
Term
| Common cause of avulsed vitreous base |
|
Definition
|
|
Term
| How may the vitreous look in the case of avulsed vitreous base |
|
Definition
| Vitreous base appears as a floating white strip |
|
|
Term
| Common location for avulsed vitreous base |
|
Definition
|
|
Term
| Description of an Avulsed Vitreous Base |
|
Definition
| Vitreous base has been pulled away from the ora serrata |
|
|
Term
| Risks associated with Avulsed Vitreous Base |
|
Definition
| concerned mainly because it was caused by trauma. Risk of vitreous hemorrhage or retinal tear/detachment |
|
|
Term
| Management of Avulsed Vitreous Base |
|
Definition
Rule out any other trauma
No other treatment unless tears/detachments are found |
|
|
Term
| Where are oral pearls often found |
|
Definition
|
|
Term
| What are oral pearls made of |
|
Definition
| Drusen like round objects found beneath dentate processes that lose their epithelial covering |
|
|
Term
| Management of Oral Pearls |
|
Definition
| None-they are benign, requrie no treatment or management |
|
|
Term
| What retinal finding appears similar to a guppy in the ora (according to Dr. Lingel) |
|
Definition
|
|
Term
| Most common location for Pars Plana cysts |
|
Definition
| Temporal retina, under vitreous base |
|
|
Term
| Pathophysiology of Pars plana cysts |
|
Definition
| Separation of nonpigmented and pigmented epithelium |
|
|
Term
Pars Plana cysts
Acquired or congenital |
|
Definition
| Acquired, increase with age, 1/3 of patients over 70 have them |
|
|
Term
| ____________________________ are more common in eyes with retinal detachments and posterior uveitis |
|
Definition
|
|
