1. FUNDOSCOPY IN PIH RETINA FUNDOSCOPY PIH
Mirror to the cardiovascular system of the body
FUNDOSCOPY
Visualization of hypertensive changes
PIH
Retinal changes run parallel with the severity of hypertension hence that of pre-eclampsia.

2. PROCEDURE ONE DROP EVERY 10 MINUTES THREE TIMES FUNDOSCOPY
AFTER ONE HOUR
BEFORE FOUR HOURS

3. SYSTEMIC HYPERTENSION
VASOSPASM
VASOSCLEROSIS
RETINOPATHY

4. NORMAL FUNDUS Uniform Caliber Smooth sinuous course
Brach at obtuse angle

5. VASOSPASM
NARROWING
STRAIGHTENING
ACUTE ANGLED
BRANCHING
A-V RATIO 1:3

6. Deflection in the course of the vein at the Arterio-venous crossing
VASOSCLEROSIS
SALU’S SIGN
Deflection in the course of the vein at the Arterio-venous crossing

7. Concealment of the vein at the Arterio-venous crossing
VASOSCLEROSIS
GUNN’S SIGN
Concealment of the vein
beneath the artery
at the Arterio-venous crossing

8. RETINOPATHY SOFT EXUDATES RETINAL HEMORRHAGES RETINAL EDEMA
HARD EXUDATES
RETINAL DETACHMENT

9. RETINOPATHY Occulsion of precapillry arteriole Capillary nonperfusion
SOFT EXUDATES
Occulsion of precapillry arteriole
Capillary nonperfusion
Localised axoplasmic stasis
Compact yellowish white fluffy lesions
Cotton wool spots

10. RETINOPATHY Fibrinoid necrosis in the vessel wall
FLAME SHAPED
HAEMORRGHAGES
Fibrinoid necrosis in the vessel wall
Located in the Nerve fibre layer of retina
Bright red flamed shaped hemorrhage

11. RETINOPATHY Increased capillary Permeability Retinal edema
MACULAR STAR
HARD EXUDATES
Increased capillary Permeability
Retinal edema
Precipitation of lipids
Discrete dense yellow lesions
Macular star

12. Accumulation of Serous fluid Retinal pigment epithelium
RETINAL DETACHMENT
LOCALISED RETINAL DETACHMENT
Accumulation of Serous fluid
between
Retinal pigment epithelium
and
Neurosensory retina

13. RETINAL DETACHMENT
TOTAL BULLOUS DETACHMENT

14. OPTIC DISC EDEMA
MALIGNANT HYPERTENSIVE RETINOPATHY

15. KEITH-WAGENER-BARKER 1939
FEATURES
K-W-R GRADING
SURVIVAL
Narrowing of the retinal arteries I
EXCELLENT
A-V CHANGES
SALU’S SIGN AND GUNN’S SIGN II
GOOD
RETINOPATHY
SOFT EXUDATES
FLAME HAEMORRHAGES
HARD EXUDATES
RETINAL EDEMA/RETINALDetachment
III
POOR
DISC EDEMA IV
VERY POOR

16. AMERICAN OPHTHALMOLOGICAL SOCEITY
K-W-R
GRADING
AOA
FEATURES O
Normal fundus I II
Focal Narrowing
Diffuse generalised narrowing
III
RETINOPATHY
SOFT EXUDATES/FLAME HAEMORRHAGES
RETINAL EDEMA/RETINAL DETACHMENT IV
DISC EDEMA

17. IMPLICATION FEATURES PREGNANCY CONTINUE RETINOPATHY TERMINATE
NORMAL FUNDUS
CONTINUE
FOCAL NARROWING
DIFFUSE NARROWING
RETINOPATHY
SOFT EXUDATES
FLAME HAEMORRHAGES
HARD EXUDATES
RETINAL EDEMA/RD
TERMINATE
DISC EDEMA

18. FUNDOSCOPY IN PIH
CONTINUE
TERMINATE

19. PROGNOSIS

20. THANK YOU