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Ophthalmoscopy
Published in Ian Mann, Alastair Noyce, The Finalist’s Guide to Passing the OSCE, 2021
Once the retina has come into focus, you should clearly be able to see blood vessels. Follow these towards the patient’s nose, until you are able to visualise the optic disc. You should then comment on the following features of the disc: colourmarginscup-to-disc ratioblurring of the optic disc, if any.
Ophthalmology
Published in Stephan Strobel, Lewis Spitz, Stephen D. Marks, Great Ormond Street Handbook of Paediatrics, 2019
Most normal cups have a cup to disc ratio of 0.3 or less. Physiological cupping (a cup to disc ratio greater than 0.7) is present in about 2% of the normal population, and glaucomatous cupping (Fig. 7.56), where there is raised intraocular pressure, with or without increased corneal diameter, increased myopia, Haab’s striae and increased axial length.
Primary Open-Angle Glaucoma and Its Variants
Published in Neil T. Choplin, Carlo E. Traverso, Atlas of Glaucoma, 2014
Mohsin Ali, Lan Lu, George L. Spaeth
Evaluation of the optic nerve forms the cornerstone of the glaucoma examination and is discussed extensively in Chapter 6. In general, most ophthalmologists employ Armaly’s cup-to-disc ratio system14 to grade and document the state of the optic nerve. While cupping is indeed a potentially important sign of glaucomatous damage, there are several problems that arise if evaluation of the optic nerve is limited only to determining the cup-to-disc ratio (Figure 9.5).
Non-arteritic Anterior Ischemic Optic Neuropathy with Macular Star following COVID-19 Vaccination
Published in Ocular Immunology and Inflammation, 2022
Abdelrahman M. Elhusseiny, Riley N. Sanders, Mohammad Z Siddiqui, Ahmed B. Sallam
On examination, his best corrected visual acuity (BCVA) was 20/25 OD and counting fingers at 3 feet OS. His intraocular pressure was 14 OD and 15 OS. Slit-lamp examination disclosed normal anterior segment examination with no anterior chamber inflammation or anterior vitritis. Dilated fundus examination showed normal optic disc, macula, retinal vessels, and periphery OD but disclosed optic disc edema (Frisen scale grade 4) in the left eye, peripapillary hemorrhages, and blunted foveal reflex (Figure 1a). The other eye cup to disc ratio was 0.2. Visual field test could not be performed because of low BCVA OS. Autofluorescence imaging revealed subtle macular hyper autofluorescence underlying an area of subretinal fluid (Figure 1b). Indocyanine green angiography showed a normal choroidal and retinal vascular filling pattern (Figure 1c). Fluorescein angiography was normal OD and disclosed optic disc leakage OS (Figure 1d). Optical coherence tomography (OCT) macula OS showed marked thickening of the peripapillary retina, intraretinal fluid and hyperreflective foci consistent with exudates, and subretinal fluid under the fovea (Figure 2).
Findings from a Rapid Assessment of Avoidable Blindness (RAAB) in the Southwest Region of Kyrgyzstan
Published in Ophthalmic Epidemiology, 2020
Brigitte Mueller, Sabina Ibraimova, Elzat Mamutalieva, Hans Limburg, Aigul Ibraimova, Ala Paduca
Visual acuity (VA) was measured using tumbling E-charts with Snellen optotypes size 6/12, 6/18 and 6/60, at 6 or 3 (6/60 only) meters distance. All measurements were taken in full daylight with available spectacle correction. If VA was <6/12 in either eye, then pinhole vision was also measured. A simple ocular examination was performed on every participant in a dark or shaded area. This included an undilated assessment of the lens using a direct ophthalmoscope. When the examined eye did not improve to 6/18 or better with pinhole examination, then the lens was dilated using mydriatic drops for further examination. Cataract was assessed according to the crystalline lens opacity. Glaucoma was defined as the principal cause of visual impairment if the optic cup-to-disc ratio was greater than 0.8, in the absence of another cause of reduced vision. For ARMD, the central retina was examined for swelling or oedema; the macula was examined for the presence of drusen, hypo- or hyper-pigmentation and neovascular changes. Any other pathologies of the retina or vitreous, e.g., retinal detachments or vitreous hemorrhages, were also noted. The principal cause of blindness or visual impairment was recorded according to WHO standards.
Lamina Cribrosa Depth and Shape in Glaucoma Suspects. Comparison to Glaucoma Patients and Healthy Controls
Published in Current Eye Research, 2019
Patrycja Krzyżanowska-Berkowska, Karolina Czajor, Piotr Syga, D. Robert Iskander
Previous studies determined the average LCD or curvature of the anterior surface in healthy subjects only,10,18,24,25 or in comparison between healthy and glaucomatous eyes.11,12,17,26,27 There is little research on LC in population with suspected glaucoma. One study by Kim et al.19 followed patients suspected of having glaucoma to determine LC changes over time. It is important to note that in that study eyes with suspected glaucoma were defined as those with ocular hypertension in the presence of a healthy-appearing optic disc or those with glaucomatous optic disc appearance. Another study by Jung et al.20 was designed to determine the relationship between the LCD and cup-to-disc ratio in glaucoma suspect subjects. Our study included only glaucoma suspects with glaucomatous optic disc appearance to determine the potential common features of LC to those reported in glaucoma patients.