Cataracts |
- Gradual, painless loss of vision
- Blurry or cloudy vision
- Difficulty seeing at night
- Halos around lights
- Fading or yellowing of colours
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- Ophthalmic Examination: Slit-lamp examination reveals lens opacity.
- Visual Acuity Test: To assess the degree of vision loss.
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- Surgical Management: Cataract extraction with intraocular lens implantation is the definitive treatment.
- Postoperative Care: Includes antibiotic and anti-inflammatory eye drops.
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Glaucoma |
- Gradual loss of peripheral vision (open-angle glaucoma)
- Severe eye pain, headache, nausea, vomiting, and sudden vision loss (acute angle-closure glaucoma)
- Halos around lights
- Optic disc cupping on examination
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- Tonometry: To measure intraocular pressure (IOP).
- Ophthalmoscopy: To assess the optic nerve for cupping.
- Visual Field Testing: To evaluate peripheral vision loss.
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- Medical Management: Topical beta-blockers, prostaglandin analogs, or carbonic anhydrase inhibitors to reduce IOP.
- Laser Therapy: Trabeculoplasty for open-angle glaucoma or iridotomy for angle-closure glaucoma.
- Surgical Intervention: Trabeculectomy or glaucoma drainage devices in refractory cases.
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Age-Related Macular Degeneration (AMD) |
- Central vision loss, difficulty reading or recognizing faces
- Distortion of straight lines (metamorphopsia)
- Drusen (yellow deposits) seen on fundoscopic examination in dry AMD
- Choroidal neovascularization in wet AMD
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- Fundoscopy: To detect drusen, retinal atrophy, or neovascular changes.
- Optical Coherence Tomography (OCT): To assess retinal thickness and detect fluid or blood under the retina.
- Fluorescein Angiography: To identify and delineate neovascularization in wet AMD.
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- Dry AMD Management: Antioxidant vitamins and zinc to slow progression.
- Wet AMD Management: Intravitreal injections of anti-VEGF agents (e.g., bevacizumab, ranibizumab) to inhibit neovascularization.
- Low Vision Aids: Magnifiers, special lenses, and rehabilitation services to maximize remaining vision.
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Diabetic Retinopathy |
- Often asymptomatic in early stages
- Blurry vision, floaters, and progressive vision loss in advanced stages
- Microaneurysms, haemorrhages, and neovascularization on fundoscopic examination
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- Fundoscopy: To detect retinal changes like microaneurysms, haemorrhages, and neovascularization.
- Fluorescein Angiography: To assess retinal blood flow and identify areas of ischaemia or neovascularization.
- Optical Coherence Tomography (OCT): To evaluate macular edema.
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- Glycemic Control: Tight control of blood glucose levels to prevent progression.
- Laser Photocoagulation: To treat proliferative diabetic retinopathy and prevent further vision loss.
- Intravitreal Injections: Anti-VEGF agents for macular edema or proliferative changes.
- Vitrectomy: Surgical removal of vitreous haemorrhage or tractional retinal detachment.
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Retinal Detachment |
- Sudden onset of floaters, flashes of light (photopsia), and a "curtain" over the visual field
- Painless loss of vision, often described as a shadow or darkness descending over one eye
- Fundoscopy reveals a detached retina, often with associated tears or holes
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- Fundoscopy: To confirm the presence and extent of retinal detachment.
- Ocular Ultrasound: If the view of the retina is obscured by haemorrhage or other factors.
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- Surgical Repair: Options include pneumatic retinopexy, scleral buckle, or vitrectomy, depending on the location and severity of the detachment.
- Laser Therapy or Cryotherapy: To seal retinal tears and prevent progression to detachment.
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Optic Neuritis |
- Sudden loss of vision in one eye, often associated with pain on eye movement
- Loss of color vision (desaturation)
- Afferent pupillary defect (RAPD) on examination
- Commonly associated with multiple sclerosis (MS)
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- Ophthalmic Examination: To detect RAPD and optic disc swelling.
- MRI of the Brain and Orbits: To assess for demyelinating lesions suggestive of MS.
- Visual Evoked Potentials (VEP): To assess the function of the optic nerve.
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- High-Dose Intravenous Corticosteroids: To reduce inflammation and speed recovery.
- Management of Underlying MS: Disease-modifying therapies if optic neuritis is associated with MS.
- Visual Rehabilitation: Supportive care and low vision aids as needed.
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