Eye - Blur Vision Part II
Eye - Blur Vision Part II
Eye - Blur Vision Part II
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Blurred vision
Scope
Review approach
Initial treatment
By cause
By symptom
By ocular signs
Visual pathway
Refractive error
Malingering
Visual loss
Pin hole
improve
Refractive error
Pen light
normal
abnormal
Opacity of cornea, Anterior chamber, Lens
Red reflex
VH, vitritis, RD
abnormal
Cataract, vitreous
opacity, retinal
disease
normal
RAPD
negative
positive
Macula to prechiasmatic optic nerve lesion
BRAO,BRVO / DR
Fundus examination
normal
Visual field
abnormal
Retinal disease
normal
Amblyopia, malingering
abnormal
Chiasmatic to occipital lobe lesion, malingering
Acute
Chronic
Chemical burn
Rupture globe
A/C: Hyphema
Symptoms
Signs
Etiology
Pupillary block
Treatment
Medication reduced
IOP
laser preripheral
iridotomy (laser PI)
CAI (Acetazolamide)
Osmotic agent (glycerine)
Topical beta-blocker
(timolol)
Pilocarpine -> give after
attack
Surgical
If uncontrolled IOP
Iris bombe
Corneal ulcer
Symptoms
Signs
Treatment
Refer to ophthalmologist
hypopyon
Chemical burn
Corneal abrasion
Hyphema
Ruptured globe
Chemical burn
Chemical burn
Epithelial defect
Corneal haze
Limbal ischemia
Chemical burn
Refer to
ophthalmologist
Perforation,Scarring ,
Neovascularization of the
cornea
Glaucoma
Cataracts
Retinal damage
Corneal abrasion
Symptoms
Signs
Treatment
Corneal abrasion
Hyphema
Symptoms
Signs
Treatment
Refer to ophthalmologist
/ evaluation or admit
Check IOP
Bed rest head elevate ->
prevent re-bleeding and
allow blood settle
Rupture globe
Symptoms
Signs
Peak
pupil
Rupture globe
Rupture globe
Initial treatment
Treatment
* ophthalmic emergency*
IOP reduction
Medication
A/C paracentesis
Refer to ophthalmologist
Refractive error
Hyperopia
Myopia
Astigmatism
Presbyopia
Physiologic condition
age>40
Blurred at near
Decrease amplitude of
accomodation
Refractive error
Treatment
Refractive surgery
( LASIK/ PRK )
Glaucoma
Signs
Medication
Surgical
Senile cataract
Symptom
Signs
Chronic progressive
visual loss
Opacification of normally
clear crystalline lens
Treatment
* surgical*
PE
ECCE
ICCE
ICCE
. Lens
Lens
PE with IOL
(
)
Diabetic retinopathy
Diabetic microangiopathy
Classifications
No DR
Non proliferative DR (NPDR)
Proliferative DR (PDR)
exudate
NVD
NVD
NVD
Pre-retinal
hge
TRD
NVI/NVG
Routine minimal
F/U
0-30
Yearly
31 and older
At time of diagnosis
Yearly
Pregnancy
(Gestational DM)
3 months
Retinal hemorrhage in a
sector of retina along retinal
vein (BRVO)
Diffuse retinal hemorrhage
in all four quadrants dilate
and tortuous retinal veins
(CRVO)
Treatment
Post- test
A
B
C
D
A anti-glaucoma drug
B laser pupillary iridotomy
C Topical steroid
D Topical atropine
Thank you
Symptoms
Risk factors
Myopia
Trauma
Aging
Signs
Elevate of neurosensory
retina from RPE by
subretinal fluid
Retinal break
Rhegmatogenous RD
Rhegma ( Gr. ) = tear
Retinal break
vitreous fluid
subretinal space
Treatment