Sequence of inspection from disc to macula LEFT EYE

Sequence of inspection from disc to macula LEFT EYE

See Table 5-13, Retinal Arteries and Arteriovenous Crossings: Normal and Hypertensive (p. 185).

See Table 5-14, Red Spots and Streaks in the Fundi (p. 186).

See Table 5-15, Light-Colored Spots in the Fundi (pp. 187-188).

■ Finally, by directing your light beam laterally or by asking the patient to look directly into the light, inspect the fovea and surrounding macula. Except in older people, the tiny bright reflection at the center of the fovea helps to orient you. Shimmering light reflections in the macular area are common in young people.

■ Lesions of the retina can be measured in terms of "disc diameters" from the optic disc. For example, among the cotton-wool patches illustrated on the next page, note the irregular patches between 11 and 12 o'clock, 1 to 2 disc diameters from the disc. It measures about one-half by one-half disc diameters.

Macular degeneration is an important cause of poor central vision in the elderly. Types include dry atrophic (more common but less severe) and wet exudative, or neovascular. Undigested cellular debris, called drusen, may be hard and sharply defined, or soft and confluent with altered pigmentation, as seen on the following page.

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