12 Station: Posterior Segment Cases

Front 1

Central Retinal Artery Occlusion

Back 1

PP: Elderly Patient

Sx: Sudden onset of painless vision loss and then transient vision loss

Test: Fundus Lens

Look for: Poor VA's, APD, Cherry Red spot on the macula, whitening of retina at posterior pole

Front 2

Central Serous Retinopathy

Back 2

PP: Young to middle aged men, under high stress or Type A personality

Sx: distortion, prolonged AI when going from light to dark

Test: Fundus Lens

Look for: blister of fluid under the macula, Amsler grid distortion (things are smaller), NO APD

Front 3

Macular Edema-- Diabetes

Back 3

PP: middle aged patient with longstanding diabetes

Sx: Gradually decreasing vision (20/25-20/50)

Test: Fundus Lens

Look for: fluid leaking out of the capillaries and causing edema in the macula, hard exudates and retinal thickening, NO APD, Amsler grid distortion

Front 4

Macular Hole

Back 4

PP: middle aged to older female

Sx: gradual painless loss of vision, central loss of vision 20/100-20/200, central spot absent on Amsler grid

Test: Fundus Lens

Look for: red hole in foveal area, NO APD

Front 5

Posterior Vitreious Detachment

Back 5

PP: middle to elderly patient

Sx: acute onset of flashes in one eye, ring floater above the ONH

Test: BIO

Look for: 20/20 in most cases, no APD, contraction of vitreous from back of eye

Must rule out retinal breaks or tears

Front 6

Retinal Detachment

Back 6

PP: Young to elderly

Sx: Curtain coming down or blurred sector of vision, preceded by flashes

Test: BIO

Look for: 20/20 unless macula is detached, + APD, milky hazy retina, floating inside the eye, fluid moves under the sensory retina via break or tear (rhegmatogenous)