PANCE Blueprint EENT (7%)

Retinal disorders (PEARLS)

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: hemorrhage, neovasculation. New abnormal vessels grow under central retina which leaks and bleed causing retinal scarring.

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.

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

  • Consult ophthalmologist
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, ranibizumabbevacizumab), intraocular corticosteroids, vitrectomy, or a combination
Orbital cellulitis (ReelDx) (Prev Lesson)
(Next Lesson) Macular degeneration (Lecture)
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