1. Dr. Ayesha Abdullah 30.1.2015

2. Learning outcomes By the end of this lecture the students would be able to; Identify the common symptoms and signs of VR disorders (VRD) and correlate them with the underlying problems with the structure and function of the VR. Identify structural landmarks on retinal photographs. Correlate the indications for commonly used investigations for the assessment of retinal disorders with the underlying pathology.

3. Some questions How do we see? What are the similarities and differences between a camera and the eye? Name part of the nervous system that can be visualized without any invasive procedure Why is the optic disc referred to as the blind spot? Have you noticed tiny bright moving dots when looking into the blue sky? Why are the photoreceptor placed posteriorly while the light enters the retina anteriorly? How do we know its day/ night?

4. Camera and the eye

5. Unlike the image from a camera the resolution of the retinal image is not uniform. Why? There are about 100 times more photoreceptors than the Ganglion cells. Why? Retina compresses images as unlike the camera.

6. Anatomical landmarks of the retina

7. What is the size of the normal optic disc? Size of the Macula? Size of fovea Thinnest part of the retina? Thickest part?

8. Common Presenting Symptoms in VRD Visual loss, mostly painless, sudden/ gradual Loss of central vision Loss of peripheral vision Loss of visual field Loss of colour vision Distorted vision; metamorphopsia, micropsia, macropsia

9. Common Presenting Symptoms in VRD Loss of contrast sensitivity Glare sensitivity Night blindness Photopsia/ flashes Floaters ; 'specks', 'flies', 'spiders' and, ‘cobweb‘, ‘mosquitoes’.

10. Loss of central vision http://www.retina-international.org/

11. Loss of peripheral vision http://www.retina-international.org/

12. Contrast sensitivity and light & dark adaptation problems

14. Glare

15. Flashes of light/ photopsia

16. Floaters

17. Colour vision deficiency http://www.achromatopsia.info/childrens-vision/

18. Field loss

19. Scotoma Negative Scotoma Positive Scotoma

21. Swollen optic disc

22. Pale optic disc

23. Macular signs

24. Retinal Haemorrhages

25. Vascular changes

26. Exudates

27. Cotton wool spots

28. Retinal Tear/ hole

29. New Vessels

33. ? RAPD

34. Quiz

37. Commonly used investigations B Scan A Scan

38. OCT

39. Angiography

40. Electroretinogram

41. 7- Functions of Retina msqheartline@hotmail.com Last date for submission 15 th February 2015