ophthalmology spot diagnosis - MIM

بسم الله الرحمن الرحيم
___
ده موضوع فيه شوية صور و على كل صورة التشخيص
+

symptoms

+

signs

+

management

الصراحة الصور و الكلام منقول من منتدى كلية الطب جامعة الملك عبد العزيز

_________

have fun with these nice ophthalmology pictures

Clinical features:
Symptoms:
Decrease visual acuity as the deposits become white and dense
Painful
Signs:
Interpalpebral deposition of calcium phosphate salts in the
subepithelial and anterior stroma with clear areas separating it from
the limbus
Clear areas and small circular areas where nerve endings perforate
the Bowman's layer are seen within the band and give it a "Swiss
cheese" appearance

Identifiable causes:
dry eye syndrome, chronic exposure keratopathy, chronic ocular
inflammation such as uveitis, phthisis bulbi, old interstitial
keratitis, long standing
glaucoma and repeated trauma such as multiple ocular surgeries.

Systemic conditions that cause increased serum calcium or phosphorus levels such as multiple myeloma, [/size]Band keratopathy developed in a silicone oil-filled eye. hyperparathyroidism, sarcoidosis, ****static disease and chronic renal failure may all lead to the formation of band keratopathy.

Association with chronic exposure to chemical irritants such as
prolonged use of pilocarpine that contain mercurial preservatives or
intraocular substances, including silicone oil for retinal detachment
repair are also noted.

Management:
Treatment is indicated for loss of visual acuity, intolerable eye irritation or
cosmesis.
Repeated application of calcium binding agent EDTA (ethylenediaminetetraacetic acid) and scraping of the corneal surface after removing the epithelium is usually effective to treat relatively mild cases.
Excimer laser phototherapeutic keratectomy[size=12] has been effectively performed
to treat more extensive cases.

Subconjunctival Hemorrhage




May occur spontaneously following minor trauma such as rubbing of the eyelid

or as a result of ocular injuries,

infections,

venous congestion,

hypertension,

vascular fragility

or other systemic conditions related to impaired blood coagulation.



Symptoms:

usually asymptomatic.



Management:

In the setting of trauma, the underlying structures must be carefully assessed to rule out possible penetrating injury.

Therapy is usually supportive using ice packs to minimize tissue
swelling and stop the bleeding in the acute phase, and for relief of
discomfort

Conjunctival Laceration






Clinical features:

May be isolated or part of more severe intraocular injuries.



Symptoms:

ocular irritation, pain and foreign body sensation.
Signs include chemosis, subconjunctival hemorrhage and torn conjunctiva.



diagnosis

Thorough eye examination under topical or general anesthesia
includes dilated fundus examination to rule out intraocular foreign
body.

Seidel test to rule out open globe injury

Ultrasonography.

CT scan to rule out intraocular foreign body.




Management:

- Observation.

- Prophylactic topical antibiotics for small lacerations.

- Surgical repair may be required for large lacerations

Conjunctival Hemangioma




Clinical features:
Symptoms:

Small-sized tumor mostly asymptomatic or cause mild ocular irritation

Spontaneous bleeding or bloody tears.




Signs:

Benign, slowly progressive, bright red patch of vessels with sometimes ill-defined margins

Typically rounded, nodular, polypoid or lobulated, may grow and reach an enormous size of mass

May be found as an isolated lesion or associated with other ocular
capillary hemangiomas or systemic diseases such as Sturge-Weber syndrome

Multiple or multi focalized hemangiomas are usually independent and
separated from one another with little connection with the surrounding
vessels.

Management:
- Observation for increase in size, number of lesions, and morphological changes.
- Surgical excision, electrolysis and thermocoagulation have been used with success