Open Open Ophtha For The Non Ophtha

Introduction to Ophthalmology
An Overview
FIRAS MADANI, MBBS, SB-OPHTH, MRCS-ED, FICO.
OCULOPLASTIC SURGEON.
KING ABDULAZIZ UNIVERSITY.
THE EYE CONSULTANTS.
‫قال تعالى‪:‬‬
‫) وفي أنفسكم أف‪ -‬تبصرون(‬
What is Ophthalmology?
In latin ophthalmous = eye , logos = though ,

science of eyes!
Ophthalmology is a clinical and surgical specialty

within medicine, that deals with the diagnosis and
treatment of eye disorders.
Importance of eye care
•Can change lives! (reversible or non-
reversible visual loss)
•Can save lives! (detecting tumors, sight

threatening or life threatening diseases)
•Disease in ophthalmology varies

between isolated ocular diseases vs
systemic diseases that affects the eye,
emergent and non emergent diseases
Introduction to
ophthalmology
Our team:
an ophthalmologist is a board-certified doctor who
completed medical and surgical training in general
ophthalmology
An optometrist is a specialist trained in the science of
optometry and treating refractive errors, contact lens
prescription
Ophthalmic nurses
Medical techs/assistants
•Multidisciplinary with other fields as well

•Referral from (ER-FM-Medical-ICU-ENT-etc)
•Referring to (Neurosurgery/neurology-ENT-Medical-ER-
ETC)
Branches of ophthalmology
These branches intergates together as the eye and adnexal structures work in harmony!
The eye is part of the human body, a lot of medical diseases can manefist in ocular
symptoms or signs
•Cornea & Anterior segment

•Glaucoma and anterior segment
•Uveitis
•Surgical retina
•Medical retina
•Pediatric ophthalmology and strabismus
•Oculoplastic and reconstructive surgery, orbit and lacrimal system
•Neuro-ophthalmology
•Ocular oncology
Worldwide
•WHO states that:
•Every 5 seconds an adult goes blind
•Every 60 seconds a child goes blind
•Approx. 45 million adults are currently blind
•Approx. 1.5 million children are currently
blind
•Approx. 135 million people who are visually
impaired
•The global cost of blindness exceeds $
167.000 million
Causes of blindness
•Developing countries: •Developed countries:
• Cataract • Age related macular degeneration
• Glaucoma • Cataract
• Trachoma • Glaucoma
• Vitamin A def. • Diabetic retinopathy
• Onchocerciasis • Refractive errors
Causes of blindness
The visual system
•The visual system and the eye
continue to grow after birth
•The visual system is a complex
Harmonious pathway ( results
in a single image produced by
intact binocular fusion )
•The eye produce a clear image
of the external environment
(refraction of light) and transmit
this image to the visual cortex
in the brain ( image of eye and
visual system )
•Extraoxular muscles play a
major role in fusion and if
disturbed diplopia can occur
The Bony Orbit
The eyelids
The Tear film
Extraocular muscles
Anatomy and physiology of the eye
Ophthalmic notes
•VA >> sc / cc
•EOM full
•Pupil: RRR no RAPD
•VF: N
•LLL: WNL
•Conj/sclera: WNL
•Cornea: clear / SPK’s / CED
•Iris/lens: N
•Fundus: Clear, flat retina , healthy ON, CDR:0.3
Basic examination
techniques
•Visual acuity test
•Tonometry
•Ophthalmoscopy
•Refraction test
•Slit lamp examination
•Visual field test
•Optical coherence tomography (OCT)
•Fundus photography
Visual acuity test
Tonometry
Ophthalmoscopy
Visual field testing
Fluorescence staining
Treatment options
•Medications
•Drops for testing ( cyclopentolate , mydriacil ,
phenylephrine, benoxinate, tetracaine , etc. )
•Antibiotics ( drops / ointment / oral / injections / IV )

•Antivirals ( acyclovir ointment ) ( topical/oral/IV )
•Lubricating (drops/ointments/gel)
•Steroids ( topical / ointment / oral / injections / IV )
•Combinations
•Others
Treatment options
•Surgery
•Others( laser, injections)
Quiz
Red Eye
Painless Red Eye ( Conjunctivitis )
Quiz
Painful Red Eye
What’s your top DDx?
20 YO myopic, suddent painless curtain like appearance?
45 YO diabetic, poorly controled, sudden loss of vision, with heavy floaters?
70 YO with gradual decreased vision over years, what can be the reason?
Painless loss of vision
Retinal detachment
Quiz
29 yo , woke up with severe ocular pain and she cannot open her eyes
Describe?
History? Risk factors?
Exam?
DDx?
Management?
Painful loss of vision
Common eye diseases
Cataracts
Glaucoma
Age-related macular degenration
Diabetic retinopathy
Refractive errors(myopia-hyperopia-astigmatism-presbyopi)
Conjunctivitis
Lens Cataract
Congenital/senile/acquired due to
trauma or inflammation or steroids
Aging of the lens proteins
Gradual (over years) painless
decreased vision
Needs surgery if visually
significant, and needs lens
replacement by IOL
Glaucoma
Congenital/juvenile/open angle/closed angle/secondary/others
Increased intraocular pressure accompanied by optic nerve disease and visual field
defects
Acute ( closed angle ) , gradual ( open angle )
NTx options include ( topical drops/oral Diamox/lasers/surgery )
Diabetic retinopathy
Microvascular pathology leading to bleeding, exudation, hemorrhages, fibrosis and
tractional retinal detachments
Decreased vision can be due to macular edema, vitreous hemorrhage, retinal
hemorrhage, tractional retinal detachment
Management include, diabetic control, intravitreal injections, laser and surgery
Refractive errors
Tx options: glasses, CL, refractive surgery
Age related macular degeneration
Old age > 65 yo
Develops in stages with time, not that common in middle eastern population
Wet AMD = macular edema due to CNVM
Dry AMD = geographical atrophy in the macula
Tx: injections, lasers
Conjunctivitis
Viral: most common , hx of flu , unilateral then bilateral, symptomatic treatment
Bacterial: heavy colored discharge, bilateral or unilateral
Allergic: hallmark is itch and tearing
Ophthalmic Emergencies
•Chemical injuries and burn
•Trauma ( open globe / eyelid laceration / orbital hematoma and retrobulbar hemorrhage )
•Orital cellulitis/preseptal cellulitis
•Endophthalmitis
•Acute angle closure glaucoma
Quiz
Chemical injuries
•Alkali or acid ( alkali is worse in prognosis )
•Check PH >> Irrigation with sodium chloride for 30 mins , check PH and IOP
•Repeat if PH is not neutralized
•Can raise IOP and cause inflammation
•Can cause limbal ischemia and corneal opacity >> graft
•Tx : irrigation/treat complications like dryness/IOP/inflammation/vision
Trauma
quiz
Quiz
endophthalmitis
•Most common presentation is preceeded by intraocular surgery or intravitreal injection
•Usually 2 to 3 days post intraocular sx/injection
•Diagnosis is clinical , Tx?
Acute angle closure glaucoma
Uveitis
•Intraocular inflammation ( not infection )
•Uveial tussiu?
•Types: ( anterior / intermediate/
posterior / Pan )
•DDx include long list and usually
managed by finding the diagnosis and
treatment in steroids (topical/injections/
oral/IV)
•Tx?
Ophthalmology as a career and
research opportunities
Thank you
•E-mail: firas_madani@Hotmail.com

Open Open Ophtha For The Non Ophtha

Uploaded by

Copyright:

Available Formats

Open Open Ophtha For The Non Ophtha

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Open Open Ophtha For The Non Ophtha

Uploaded by

Copyright:

Available Formats

Introduction to Ophthalmology

In latin ophthalmous = eye , logos = though ,

Ophthalmology is a clinical and surgical specialty

•Can save lives! (detecting tumors, sight

•Disease in ophthalmology varies

•Multidisciplinary with other fields as well

•Cornea & Anterior segment

•Antibiotics ( drops / ointment / oral / injections / IV )

45 YO diabetic, poorly controled, sudden loss of vision, with heavy floaters?

You might also like