Statistics and Associations

• Leakage of fluid leading to a blister in the subretinal space
• Commonly associated with type A personality and recent stress
• Most common in males (10:1), more common in whites (rare in blacks)
• 45% recurrence rate within one year
• 5% develop new blood vessel growth under the retina (SRNVM)
• 95% end up with vision better than 20/40

Management

• Amsler grid for daily monitoring
• No treatment necessary (usually resolves within 3 months)

Statistics and Associations

• Risk factors: macular swelling, macular traction, trauma, idiopathic
• 10-20% chance of developing macular hole in fellow eye

Management

• Amsler grid for daily monitoring
• No treatment for mild macular holes due to the possibility of spontaneous closure
• Surgical intervention (PPV with membrane peel, air-fluid exchange, gas injection). Requires face down positioning for weeks
• Poor prognosis if macular hole has been present for one year

Statistics and Associations

• Common with blood pressure above 140/90
• Generally asymptomatic
• Sclerosed arteries, vessel tortuosity, and vessel crossing abnormalities are the most common changes
• Optic nerve head swelling, dilated tortuous veins seen with malignant hypertension

Management

• Medical consult to treat underlying hypertension

Statistics and Associations

• Associated with high blood pressure (67%), Carotid Occlusive Disease (25%), Diabetes (33%), Cardiac Valve Disease (25%)
• 80% will end up with vision better than 20/40 if macular area not involved
• Most will have permanent visual field defects
• Mild association with stroke

Management

• Medical Evaluation with complete cardiovascular evaluation including electrocardiogram, echocardiogram, carotid doppler studies

Statistics and Associations

• Obstruction of the retinal venous drainage system usually due to a hardened artery pressing on a retinal vein
• Associated high blood pressure (60%), Glaucoma (40%), Diabetes, Heart Disease, rarely Hypercoagulable States (conditions that cause blood to be thicker than normal)
• 50% will have Macular edema, 20% will develop epiretinal membranes
• 50% will have better than 20/40 visual acuity

Management

• Medical evaluation with attention to cardiovascular system to treat underlying cause
• If macular involvement, intraocular injection of anti-VEGF agent.
• New blood vessel growth may require laser treatment

Statistics and Associations

• Obstruction of the retinal venous drainage system usually due to a hardened artery pressing on the central retinal vein
• Associated high blood pressure (60%), Glaucoma (40%), Diabetes, Heart Disease, rarely Hypercoagulable States (conditions that cause blood to be thicker than normal)
• Major complications include new blood vessel growth and macular swelling

Management

• Medical evaluation with attention to cardiovascular system to treat underlying cause
• Ocular injection of anti-VEGF agent now standard of care
• Gonioscopy at each visit
• New blood vessel growth may require laser treatment

Statistics and Associations

• Detachment of the vitreous from the retina
• 53% by age 50, 65% by age 65
• 10% – 15% risk of retinal break with acute PVD
• 70% risk of retinal break if vitreous hemorrhage is present

Management

• For acute PVD: follow in 2-4 weeks to rule out retinal break
• Patient education regarding signs/symptoms of retinal detachment

Statistics and Associations

• Calcium phosphate material attached to vitreous
• 75% unilateral
• 30% association with diabetes
• Typically no effect on vision

Management

• No treatment necessary

Statistics and Associations

• Characterized by an abnormal accumulation of white fibrillar material in the anterior chamber
• Commonly seen after fifth to sixth decade of life
• Increased intraocular pressure changes noted in 50% of pseudoexfoliation syndrome patients within ten years of diagnosis

Management

• No treatment recommended unless glaucomatous changes occur
• Laser treatments quite effective as well as topical medications

Statistics and Associations

• Liberation of iris pigment cells into anterior chamber can clog drainage canal and increase pressure
• Typically first seen in white males between 20–40 years old
• Visual fluctuations common with physical exertion
• Pigmentary glaucoma occurs in approximately 10-20% of patients
• If glaucomatous changes occur from PDS, usually happen before fifth decade of life

Management

• No treatment recommended unless glaucomatous changes occur
• Laser treatments quite effective as well as topical medications