Adam,Rouilly AR403 - Page 18

Condion 9
This view is of the opc disc and temporal rena
The main clinical features are:
• Opc disc with uniform central cup with cup
disc rao <0.5 and normal
neurorenal rim
• Renal vessels and macula look normal
• This degree of darker redness in the central
macular area (fovea centralis) is normal
• The slight darkening of the peripheral renal
vessels is also normal
This diagnosis is consistent with:
NORMAL FUNDUS (OPTIC DISC AND RETINA)
Comment:
Sequence for looking at the rena:
• Light reex for cataract, corneal arcus, xanthelesma, conjuncva
• Start at the opc disc
• Superior temporal arcade and inferior temporal arcade
• Macular area
• Superior nasal arcade and inferior nasal arcade
• Peripheral, clockwise sweep to look for peripheral lesions
Condion 10
This view is of the posterior pole centred on the opc disc
The main clinical features are:
• Large cup disc rao (>0.5) indicang cupping
of the opc disc
• Superior polar notching
• Nasal displacement of central blood vessels
This diagnosis is consistent with:
GLAUCOMA
Comment:
Large cup disc rao (>0.5). This means that the cup (central circle) to disc diameter is
> 0.5). The normal rao is 0.3. Tonometry will reveal increased vitreal pressure (usually
greater than 16 mmHg at diagnosis). Glaucomatous damage and its extent is conrmed by
visual elds and tomographic imaging techniques. Central scotoma and a painful eye in most
cases. Consider as cause of severe headache. The diagnosis is an emergency as ongoing
ischaemia due to pressure can precipitate visual loss.
18
Important and Common Renal Condions: Condions 9 - 22
Condions and Diseases of the Rena