VRICS // RETINAL AND MACULAR CONDITIONS Hospital optometrist, Stanley Keys presents a range of clinical images relating to retinal and macular conditions that may be encountered in routine practice to test recognition and knowledge skills. 1 CET POINT Cases of retinal and macular disease Stanley Keys BSc (Hons), FCOptom, Dip Glauc, Dip Tp (IP) ABOUT THE AUTHOR 50 Course code: C-38983 Deadline: March 6, 2015 Stanley Keys is principal optometrist and clinical teacher at Ninewells Hospital in Dundee. He also works in private optometric practice and has gained independent prescribing status, as well as the College of Optometrists Diploma in Glaucoma. He is active in optometric education through his work with NHS Education Scotland and works with Optometry Scotland on professional development. LEARNING OBJECTIVES To be able to recognise the appropriate management steps for a range of retinal conditions (6.1.3) To be able to identify retinal abnormalities and manage appropriately (Group 6.1.5) LEARNING OBJECTIVES To be able to explain to patients about the role of orthokeratology in refractive management (Group 1.2.4) To understand the contact lens fitting techniques used in orthokeratology (Group 5.1.1) Exam questions Under the enhanced CET rules of the GOC, MCQs for this exam appear online at www.optometry.co.uk/cet/exams. Please complete online by midnight on March 6, 2015. You will be unable to submit exams after this date. Answers will be published on www.optometry.co.uk/cet/exam-archive and CET points will be uploaded to the GOC every two weeks. You will then need to log into your CET portfolio by clicking on ‘MyGOC’ on the GOC website (www.optical.org) to confirm your points. optometrytoday CET IN ONE PLACE live bookshop CET Points for Optoms, DOs, CLOs and IPs www.optometry.co.uk/cet online enewsletter tv VRICS January 10, 2015 For the latest CET visit www.optometry.co.uk/cet References Visit www.optometry.co.uk/clinical, click on the article title and then on ‘references’ to download SE VEN CE T PO IN AVAILA TS BL ONLINE E NOW VRICS Image A Image B A patient presents with a moderate reduction to vision in the right eye is the most likely diagnosis from the images 01 What shown? a/ Full thickness macular hole b/ Geographic atrophy c/ Central serous chorioretinopathy d/ Retinoschisis 51 02 Which group of patients does this most commonly 04 What is the most likely diagnosis from the images 03 What is the most likely management of this 05 Which of the following statements in relation to this affect? a/ Females in sixth or seventh decade of life b/ Males in third or fourth decade of life c/ Males in sixth or seventh decade of life d/ Females in third or fourth decade of life condition in the majority of cases? a/ No active treatment as usually resolves spontaneously b/ Macular grid laser c/ Intravitreal therapy with ranibizumab d/ Photodynamic therapy shown? a/ Central serous chorioretinopathy b/ Cystoid macular oedema c/ Dry macular degeneration d/ Wet macular degeneration condition is incorrect? a/ It can occur following routine cataract extraction b/ Central vision and near acuity can be reduced c/ Patients with this finding are always asymptomatic d/ Referral to an ophthalmologist for formal diagnosis and treatment is the appropriate course of action 06 Which of the following may increase the risk of developing the condition? a/ Diabetic retinopathy b/ Retinal vein occlusion c/ As a result of complications arising during cataract surgery d/ All of the above For the latest CET visit www.optometry.co.uk/cet January 10, 2015 VRICS // RETINAL AND MACULAR CONDITIONS //REFLECTIVE LEARNING Having completed this CET exam, consider whether you feel more confident in your clinical skills – how will you change the way you practice? How will you use this information to improve your work for patient benefit? Image C 07 Which of the following best describes the macular 52 changes shown in the image? a/ Wet macular degeneration with haemorrhage b/ Large full thickness macular hole c/ Early dry macular degeneration with drusen and pigment d/ Geographic atrophy due to advanced dry AMD 08 Which of the following symptoms is least likely to be experienced by this patient? a/ Problems navigating – often bumping into objects b/ Difficulty recognising faces c/ Difficulty with reading newspapers d/ Unable to read text on the television screen 09 Which of the following statements in relation to the management of this patient is incorrect? a/ S moking and dietary advice is indicated to try to reduce disease progression b/ This is treatable with intravitreal injections of ranibizumab c/ Referral to the low visual aid clinic may help with reading techniques d/ Some patients with this condition may be eligible for partial sight or blind registration 7, 8, 7 9 -February 2015 SAT MON 9 FEBRUARY 2015 Excel London EXCEL LONDON January 10, 2015 For the latest CET visit www.optometry.co.uk/cet Image D is the diagnosis from the image shown? 10 What a/ Central retinal artery occlusion b/ Diabetic maculopathy c/ Wet macular degeneration d/ Central retinal vein occlusion of the following statements in relation to this 11 Which condition is incorrect? a/ Glaucoma can be secondary complication b/ The ischaemic form of this condition presents with mild visual loss and no relative afferant pupilary defect (RAPD) c/ Fluorescein angiography is useful in determining whether the presentation is ischaemic or nonischaemic d/ The non-ischaemic form of this condition is more common than the ischaemic form of the following statements in relation to the 12 Which management of this condition is incorrect? a/ P an-retinal laser photocoagulation is never used to reduce neovascularisation in these cases b/ Intravitreal ranibizumab may be used as a treatment option c/ Blood tests need to be carried out in order to identify and treat the underlying cause d/ Patients should be followed up to check for secondary glaucoma REGISTER NOW AT 100percentoptical.com