PANCE Blueprint EENT (7%)

Retinal disorders (PEARLS)

NCCPA™ PANCE EENT Content Blueprint eye disorders ⇒ retinal disorders

Macular degeneration Gradual painless loss of central vision. The macula is responsible for central visual acuity which is why macular degeneration causes gradual central field loss.

  • Metamorphopsia (distortion on Amsler grid)
  • Dry macular degeneration (85% of cases): atrophic changes with age – a slow gradual breakdown of the macula (macular atrophy), with DRUSEN (DRY) = yellow retinal deposits.
  • Wet macular degeneration: an advanced form of dry age-related macular degeneration. New blood vessels growing beneath the retina (neovascularization) leak blood and fluid, damaging the retinal cells. These small hemorrhages usually result in rapid and severe vision loss

TX: Wet age-related macular degeneration

  • VEGF inhibitors (e.g., bevacizumab)
  • Photodynamic therapy
  • Zinc and antioxidant vitamins

Dry age-related macular degeneration

  • Zinc and antioxidant vitamin
Retinal detachment Vertical curtain coming down across the field of vision may sense floaters or flashes at onset, loss of vision over several hours

  • Fundoscopic exam: asymmetric red reflex
  • Myopia (nearsightedness) is a risk factor for the development of retinal detachment
  • Retinal detachment usually presents with defects in the peripheral visual field

TX: Stay supine (lying face upward) with head turned towards the side of the detached retina

  • Consult ophthalmologist
  • Pneumatic retinopexy is a procedure for the management of retinal detachment that involves cryoretinopexy followed by injection of an air bubble in the vitreous
Retinopathy Leading cause of blindness most common is diabetic retinopathy

TX:  control of blood glucose and BP

  • Ocular treatments: retinal laser photocoagulation, intravitreal injection of antivascular endothelial growth factor drugs (eg, ranibizumab, bevacizumab), intraocular corticosteroids, vitrectomy, or a combination
Orbital cellulitis (ReelDx) (Prev Lesson)
(Next Lesson) Macular degeneration (Lecture)
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