Fundoscopy slides discussion

Discussion in 'Plab 1 and 2 forum' started by Guest, Jan 15, 2005.

  1. Guest

    Guest Guest

    check if opthalmoscope is in good working condition
    inform examiner that u would tell the pt that u r going to flash bright light in his eyes to have a look at the back of his eyes and during examination u will come very near to his face
    ask him to fix his gaze at a distant object
    DIM LIGHTs
    examination of rt eye e ophthalmoscope held in rt hand and look through e ur rt eye vice versa is for lt eye
    --hold instrument to eye e index finger on thelens dial
    --approach from shallow angel (15--20 degree)
    approach on the same level as equator
    --note and comment on red reflex
    --note and comment on anterior surface of eye
    --come near and focus on retina
    --identify optic disc and comment on colour ,cup,size and margins
    --follow blood vessels in 4 quadrants
    --seek to identify the macula and fovea
    --some times 2 eyes of dummy will have 2 different pathologies
    --report ur findings to the examiner

    common slides kept r
    hypertensive retinopathy
    -diabetic retinopathy
    3--pappiloedema
    --normal
  2. Guest

    Guest Guest

    diabetic retinopathy

    [​IMG]

    diabetic retinopathy (lazer)
    extensive pan retinal photocoagulation for previous proliferative retinopathy
    macula looks healthy, visual acuity at this stage is 6/9 and would be maintained at this level
  3. Guest

    Guest Guest

    [​IMG]

    diabetic retinopathy(maculopathy)

    rt fundas of young type 1 diabetic showing hard exudate close to macula.visual acuity is 6/5,this is an early case of diabetic maculopathy and may require laser treatment
  4. Guest

    Guest Guest

    [​IMG]


    diabetic retinopathy(background_)
    fundas photograph rt eye, dot and blot haemorrhagess mainly temporal to the macula and a nerve fiber haemorrhage in the upper part of fundas,there is a cresent temporal to the optic disc which is e in normal limits
  5. Guest

    Guest Guest

    [​IMG]

    diabetic retinopathy(proliferative)
    fine new vessels on the optic disc,dot/blot haemorrhages elsewhere, rainbow type leison in the lower part of the pic is an artefact,pt require panretinal photocoagulation to preserve vision
  6. Guest

    Guest Guest

    diabetic retinopathy(maculopathy and cotton wool spot)

    [​IMG]

    diabetic retinopathy(maculopathy and cotton wool spot)
    area of hard exudate adjacent to lt macula(circinate) e central dot haemorrhages,cotton wool spot(retinal ischemia) inferior to optic disc,visual acuity 6/6, for focal laser
  7. Guest

    Guest Guest

    [​IMG]

    diabetoic retinopathy(maculopathy)
    exudation temporal to macula and close to the fixation marker in the lt eye ,there r dot and blot haemorrhages temporal to macula ,this is classified as diabetic maculopathy
  8. Guest

    Guest Guest

    [​IMG]

    diabetic retinopathy(microaneurysm)
    there r some red dots in the fundas which represent microaneurysm and small dot haemorrhages, the optic disc is normal and the optic disc vessel on it r also e in normal limits
  9. Guest

    Guest Guest

    NORMAL FUNDOSCOPY IMAGE

    [​IMG]

    NORMAL!!!
  10. Guest

    Guest Guest

    HYPERTENSIVE RETINOPATHY

    [​IMG]

    HYPERTENSIVE RETINOPATHY
  11. Guest

    Guest Guest

  12. Guest

    Guest Guest

    [​IMG]

    Acute closed angke glaucoma

    ---------------------------------------------------------
    [​IMG]

    this is a microangiopathy chacterized by microaneurysm, dot and blot haemorrhages causing occlusion and leakage resulting in retinal ischemia
  13. Guest

    Guest Guest

    proliferative diabetic retinopathy

    proliferative diabetic retinopathy

    [​IMG]
  14. Guest

    Guest Guest

    [​IMG]

    Image showing the funduscopic findings in miliary tuberculosis - note the pale lesions (marked by arrow) representing tuberculous infiltrates of the choroid. Miliary tuberculosis is a complication of primary infection with Mycobacterium tuberculosis. Miliary TB most frequently affects the lungs (90%), meninges (tuberculous meningitis 25%), liver/spleen, kidneys, adrenal glands and the choroid
  15. Guest

    Guest Guest

    [​IMG]

    this is a central retinal vein occlusion,the central vein became blocked and hydrostatic pressure developed which resulted in multiple ruptures e i n the capillary bed of the retina giving the appearance of 360 degree of retinal haemorrhage
  16. Guest

    Guest Guest

    [​IMG]

    retinal vein occlusion
    retinal ischemia leading to neovascularisation which increases the risk of intraoccular haemorrhage
  17. Guest

    Guest Guest

    papiloedema

    papiloedema

    [​IMG]
  18. Guest

    Guest Guest

  19. Guest

    Guest Guest

  20. Guest

    Guest Guest

    [​IMG]
    In the nonproliferative stage, capillaries are damaged. But weak new capillaries haven't started to grow on the



    -------------------------------------------------------------------------------------


    [​IMG]
    In the proliferative stage, weak new capillaries are growing throughout the retina. Bleeding into the vitreous may occur.
  21. Guest

    Guest Guest

  22. Guest

    Guest Guest

  23. Guest

    Guest Guest

    Papilledema showing blurred disc margins and dilated tortuou

    [​IMG]

    Papilledema showing blurred disc margins and dilated tortuous vessels
  24. Guest

    Guest Guest

    IDDM

    IDDM


    1--explain to the examiner that u would introduce to the pt


    2--explain to the examiner that u would ask permission of the patient to examine the back of his eye


    3--explain to the examiner that u would darken the room and ask pt to focus on an object in the far corner and not look directly into ophthalmoscope


    4--assess the lens for opacity which is common eye finding in diabetics
    there should be an absence of red reflex if present and an inablity to assess the fundus


    5--once cataract hasbeen excluded, assess the iris for rubeosis(new vessel formation),which puts the pt at risk for glaucoma


    6--assess the retina ,in the examination a slide is projected

    BACKGROUND DIABETIC RETINOPATHY(NON PROLIFERATIVE)
    appears as exudates.haemorrhages and microaneurysms.Microaneurysm leak plasma and lipid seen as hard exudate,Soft exudates r site of small retinal infarcts
    IN PROLIFERATIVE DIABETIC RETINOPATHY COMMON IN IDDM AFTER "20 YEARS
    there is a new vessel formation near the optic disc and fibrosis, The pt is then at the risk for haemorrhage,retinal detachment and ultimately blindness


    7--repeat the examination on opposte side


    8--explain to the examiner that u would thank the pt for cooperation
  25. Guest

    Guest Guest

    Hypertensive retinopathy FINDINGS
    look for the signs of vascular disease
    copper wiring of arteris (GRADE1)
    --arteriovenous nipping(2)
    --flame and blot haemorrhages and cotton wool exudates(3)
    --papiloedema(4)
  26. Guest

    Guest Guest

    Cotton Wool spots result from occlusion of retinal pre-capillary arterioles supplying the nerve fibre layer with concomitent swelling of local nerve fibre axons. They are white, flufy lesions in the nerve fibre layer. They are very common in Diabetic Retinopathy, especially if the person is also hypertensive.

    Hard exudates are yellow deposits of lipid and protein within the sensory retina. Accummulations of lipids leak from surrounding capillaries and microaneuryisms, they may form a circinate pattern
  27. Guest

    Guest Guest

  28. Guest

    Guest Guest

    proliferative Diabetic Retinopathy

    The above image was non proliferative,

    The Image below is Proliferative

    proliferative Diabetic Retinopathy
    [​IMG]
  29. Guest

    Guest Guest

    Fundoscopy

    [​IMG][/img]
  30. Guest

    Guest Guest

    Central Retinal Artery Occlusion (CRAO)

    [​IMG]

    Central Retinal Artery Occlusion (CRAO)
  31. Guest

    Guest Guest

    Central Retinal Venous Occlusion (CRVO)

    Central Retinal Venous Occlusion (CRVO)
    Blood and thunder” – optic disc blurring, macular edema, pan-retinal hemorrhages, tortuous dilated veins, cotton wool spots

    [​IMG]
  32. Guest

    Guest Guest

  33. Guest

    Guest Guest

    cool

    :arrow: This is one good post, Thanks pal
    :lol:
  34. Guest

    Guest Guest

    thanks so much for taking the time to do this post. Its brilliant!!!
  35. 1 guest

    1 guest Guest

    thank you very much
  36. Guest

    Guest Guest

    fantastic information!

    thank you very much for all the information you put on line for us!
    Very professional
    very technical
    I haven't seen anything like this on this forum.
    it is a masterpiece!
    Daniela
  37. Guest

    Guest Guest

    its really amazing!!!
  38. Guest

    Guest Guest

    Re: proliferative diabetic retinopathy

    :lol: :cry:
  39. satya

    satya Guest

    it is a wonderful and very useful post .
    thank u very much
  40. mahjabeen

    mahjabeen Guest

    Re: Papilledema showing blurred disc margins and dilated tor

  41. Guest

    Guest Guest

  42. aziz7

    aziz7 Guest

    thanks

    thanks for such a beutiful demonstrtion of fundoscopic slide
  43. l_qayam

    l_qayam Guest

    to describe fundal examination

    can any one tell me very nicely how to describe different conditions on fundoscopic examination to an examiner.
    :?: thanks :lol:
  44. Guest

    Guest Guest

    thank a lot for such a nice description
  45. marsman

    marsman Guest

    thanks a lot friend.. you have shared a gud amt of info quite clearly with simplicity...

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