Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.
-
Upload
silvia-chastity-harper -
Category
Documents
-
view
217 -
download
0
Transcript of Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.
![Page 1: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/1.jpg)
Visual lossDr Amani Badawi
ASSISTANT PROFESSOR
OPHTHALMOLOGY
04/21/23Amani Badawi
![Page 2: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/2.jpg)
![Page 3: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/3.jpg)
Acute Visual Loss
![Page 4: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/4.jpg)
Acute visual loss
![Page 5: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/5.jpg)
History
• Age
• POH & PMH
• Onset
• Duration
• Severity of visual loss compared to baseline
• Monocular vs. binocular ?
• Any associated symptoms
• Visual acuity assessment
• Visual fields
• Pupillary reactions
• Penlight or slit lamp examination
• Intraocular pressure
• Ophthalomoscopy
- red reflex
- assessment of clarity of media
- direct inspection of the fundus
Examination
![Page 6: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/6.jpg)
1-Central Retinal Artery Occlusion (CRAO)
• True ophthalmic emergency!
• Sudden painless and often severe visual loss
• Permanent damage to the ganglion cells caused by prolonged interruption of retinal arterial blood flow
• Characteristic “ cherry-red spot ”
• Months later, pale disc (optic atrophy) due to death of ganglion cells and their axons
![Page 7: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/7.jpg)
1-Central Retinal Artery Occlusion (CRAO) treatment
• As before +
• Ocular massage:
-To dislodge a small embolus in CRA and restore circulation
-Pressing firmly for 10 seconds and then releasing for 10 seconds over a period of ~ 5 minutes
• Ocular hypotensives, vasodilators, paracentesis of anterior chamber
•
![Page 8: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/8.jpg)
2-Branch Retinal Artery Occlusion (BRAO)
• Sector of the retina is opacified and vision is partially lost
• Most often due to
embolus
• Treat as CRAO
![Page 9: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/9.jpg)
3-Central Retinal Vein Occlusion (CRVO)
• Acute loss of vision
• Disc swelling, venous engorgement, cotton-wool spots and diffuse retinal hemorrhage.
• Needs medical evaluation
• Long term complication: neovascular glaucoma, and macular edema so periodic ophthalmic follow up
![Page 10: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/10.jpg)
4-Optic Nerve Disease
• Non-Arteritic Ischemic Optic Neuropathy (NAION)
- vascular disorder
pale, swollen disc +/- splinter hemorrhage
loss of VA , VF ( often altitudinal )
- Treatment : systemic steroids
![Page 11: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/11.jpg)
4-Optic Nerve Disease
• Optic neuritis - idiopathic or associated with multiple
sclerosis - young adults - Unilateral decreased visual acuity and colour
vision -RAPD -pain with ocular movement -bulbar (disc swelling) or retrobulbar (normal
disc)
![Page 12: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/12.jpg)
5-Retinal Detachment• Retinal detachment
- flashes, floaters, shade over vision
- elevated retina +/- folds
• Macular disease
- decrease central vision
- metamorphopsia
![Page 13: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/13.jpg)
Amani Badawi
Separation of sensory retina from RPE by subretinal fluid (SRF)
Rhegmatogenous - caused by a retinal break
Non-rhegmatogenous - tractional or exudative
![Page 14: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/14.jpg)
Trauma6-Trauma
![Page 15: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/15.jpg)
Hyphema
![Page 16: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/16.jpg)
Ruptured globe
• Open globe should be suspected in any patient who has a history of trauma to the eye, especially with a laceration or puncture wound that extends through the eyelid, followed by pain and decreased visual acuity &hyptony.
![Page 17: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/17.jpg)
Amani Badawi
Anterior segment complications of blunt trauma
Sphincter tear
Cataract Angle recession
Hyphaema
Lens subluxation
Iridodialysis Vossius ring
Rupture of globe
![Page 18: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/18.jpg)
Macular hole Optic neuropathy RD
Posterior segment complications of blunt trauma
Choroidal rupture and haemorrhageCommotio retinae Avulsion of vitreous base
and retinal dialysis
![Page 19: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/19.jpg)
Amani Badawi
Complications of penetrating trauma
Flat anterior chamber
Vitreous haemorrhage
Damage to lens and iris
EndophthalmitisTractional retinal detachment
Uveal prolapse
![Page 20: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/20.jpg)
7-Media Opacities• Corneal edema: - ground glass appearance - as in acute congestive
glaucoma
• Corneal abrasion &ulcer• Vitreous hemorrhage - traumatic - retinal neovascularization
![Page 21: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/21.jpg)
8-Endophthalmitis
Background: Bacterial endophthalmitis is an inflammatory reaction of the intraocular fluids or tissues caused by microbial organisms.
![Page 22: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/22.jpg)
History
Classification is based on routes of entry.
•Exogenous
•Endogenous
![Page 23: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/23.jpg)
Physical General findings
•Visual acuity decreased below the level expected
•Lid edema
•Conjunctival hyperemia
•Corneal edema
•Anterior chamber cells and flare &Hypopyon
•Vitritis
•Loss of red reflex
•Retinal periphlebitis if view of fundus possible
![Page 24: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/24.jpg)
9-Visual Pathway Disorders
Hemianopia
- Causes: vascular or tumors
-Types
Cortical Blindness
- Extensive bilateral damage to cerebral pathways
- Normal pupillary reactions and fundi
![Page 25: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/25.jpg)
Chronic Visual Loss
![Page 26: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/26.jpg)
Case 1
• A 75 year old woman is seen for an annual physical examination and complains of mild difficulty in reading and seeing street signs
• Vision is especially worse at night
• PHx: HTN, T2DM diet controlled
• O/E: VA R 6/18 and L 6/12
![Page 27: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/27.jpg)
Case 1• What is the likely diagnosis?
![Page 28: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/28.jpg)
1-Cataract
• Symptoms gradual over years
• 1. Reduction in visual acuity
• Worsening of existing myopia
• Correction of hyperopia “second sight of the aged”
• 2. Loss of contrast sensitivity in low light
• 3. Glare in bright light :Forward scatter of light
![Page 29: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/29.jpg)
Case 2
• A 76 year old man has noted visual distortion over the past week
• Straight lines viewed through his right eye dipped down in the centre
• Round plates seem to have “edges”
• O/E: VA R 6/18 and L 6/6
• What is the likely diagnosis?
• What test are you going to do?
![Page 30: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/30.jpg)
Case 2
![Page 31: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/31.jpg)
Case 2
![Page 32: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/32.jpg)
Case 2
![Page 33: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/33.jpg)
2-Macular degeneration• Loss of central vision
• Reading, recognizing faces impaired
• Leading cause of legal blindness in developed world
• Multifactorial• Age
• Smoking, vascular disease, UV light, diet, FHx, …
• Atrophic (dry) or exudative (wet)
![Page 34: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/34.jpg)
Geographic atrophy – dry AMD
![Page 35: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/35.jpg)
Choroidal neovascularisation – wet AMD
![Page 36: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/36.jpg)
Macular scarring – wet AMD
![Page 37: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/37.jpg)
Management – dry AMD
• Lifestyle
• Stop smoking, reduce UV exposure, Zinc & antioxidants
• Low vision aids
• Legal blindness and driving
• Monitoring with Amsler chart
![Page 38: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/38.jpg)
Management – wet AMD =CNV
• Observation• Laser photocoagulation
• Photodynamic therapy (PDT)
• Intra-vitreal injection of Anti-VEGF
![Page 39: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/39.jpg)
Anti-VEGF therapies
• VEGF-A stimulates angiogenesis and vascular permeability
• Intravitreal injection of monoclonal antibodies
• Ranibizumab (Lucentis) • Off-label Bevacizumab (Avastin)
![Page 40: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/40.jpg)
Case 3
• A 68 year old man was referred from his optometrist for visual field testing
• He has not reported any problems with vision, but the test report shows a reduction in peripheral vision in the Right eye
![Page 41: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/41.jpg)
Case 3
• What is your likely diagnosis?
• What further examination are you going to do?
![Page 42: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/42.jpg)
Case 3LE RE
![Page 43: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/43.jpg)
3-Glaucoma
• 1. Optic nerve damage (optic disc cupping)
• Increased Cup:disc ratio
• Loss of neuroretinal rim
• 2. Increased IOP
• 3. Peripheral visual defects
![Page 44: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/44.jpg)
The trick of IOP
• Only 10% with IOP>21 have glaucoma
• The rest have ocular hypertension
• Only 50% of glaucoma patients have IOP>21
• The rest have normal tension glaucoma
![Page 45: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/45.jpg)
Glaucoma
• Types
• Primary
• Open angle (90%)
• Closed angle
• Secondary
• Congenital
![Page 46: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/46.jpg)
Primary open angle glaucoma
• “The silent thief of sight”
• Asymptomatic
• Usually detected on routine examination
• Risk factors: IOP, age, FHx, DM, myopia
• Impaired drainage of aqueous humor through trabecular meshwork
• Due to age-related morphological changes
![Page 47: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/47.jpg)
Primary open angle glaucoma
![Page 48: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/48.jpg)
Management
• Aim to stop progress
• Medical – reduction of aqueous secretion
• Beta-blockers (Timolol)
• Alpha-agonists (Brimonidine)
• Prostaglandin analogues (Latanoprost)
• Parasympathomimetics (Pilocarpine)
• Carbonic anhydrase inhibitors (Brinzolamide)
![Page 49: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/49.jpg)
Management
• Surgical
• Argon and selective laser trabeculoplasty
• Filtering surgery
• Trabeculectomy
• Laser peripheral iridotomy : Yag laser
![Page 50: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/50.jpg)
Case 4
• A 13 year old girl is seen for physical examination at school. She admits to difficulty in reading the blackboard, but not in reading textbooks. She does not wear glasses.
• O/E: VA R 6/36 ph 6/6 and L 6/36 ph 6/6
• What is your diagnosis?
![Page 51: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/51.jpg)
4-Refractive error
• Corrects with pinhole
• Management: glasses, contact lenses, refractive surgery
![Page 52: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/52.jpg)
Case 5 – spot diagnosis
![Page 53: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/53.jpg)
5-Retinitis pigmentosa
• Genetically inherited
• Progressive retinal dystrophy
• Night blindness, tunnel vision, legal blindness
• Bony spicules from mottling of RPE
• Incurable
• Future: gene therapy, bionic eye, …?
![Page 54: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/54.jpg)
6 – diabetic retinopathy
• Microvascular retinal changes
• Blindness is progressive, but preventable
• Annual retinal examination
• Tight T2DM control HbA1c 6-7%
• laser treatment
• Pre-proliferative retinopathy
• Proliferative retinopathy
• Also predisposes to cataract & glaucoma
![Page 55: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/55.jpg)
Diabetic retinopathy
![Page 56: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/56.jpg)
Diabetic retinopathy
![Page 57: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/57.jpg)
Diabetic retinopathy
![Page 58: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/58.jpg)
Diabetic retinopathy
![Page 59: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/59.jpg)
Diabetic retinopathy
![Page 60: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/60.jpg)
Diabetic retinopathy
![Page 61: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/61.jpg)
Diabetic retinopathy
![Page 62: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/62.jpg)
Diabetic retinopathy
![Page 63: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/63.jpg)
Diabetic retinopathy
![Page 64: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/64.jpg)
Summary
Causes of chronic visual loss• Cataract
• Glaucoma
• Age-related macular degeneration
• Refractive error
• Retinitis pigmentosa
• Diabetic retinopathy
![Page 65: Visual loss Dr Amani Badawi ASSISTANT PROFESSOR OPHTHALMOLOGY 10/5/2015Amani Badawi.](https://reader035.fdocuments.in/reader035/viewer/2022062519/56649e865503460f94b89855/html5/thumbnails/65.jpg)
Thank you