Friday, October 31, 2008

More pearls of fundoscopic exam temporal pallor and atrophy

Pallor is noted in any process affecting maculopapillary bundle.  The disk is alabaster white and bound by a gray white cup.  Green light of the opthalmoscope shows the fibers as they enter the disk. 
Optic atrophy has seven major features:   1) pale aspirin-white disc.  2)  sharp margins  3) loss of lamina cribosa  4)  increased cup to disc ratio  5) decreased arterioles off disc (less than 14)  6)  small arteries and 7) gray pale retina. 
Swelling has seven features  1) Loss of disk margin, superior then inferior then temporal  Always blurred nasal margins  2)  Fat veins without pulsations   3)  Erythema off the disk  4)  loss of lamina cribosa, whole disc pushed forward  5)  Slit hemorrhages off disc margin  6)  engorged veins appear and disappear near macula   7)  Folds in retina spread towards the macula.  Last normal acuity.

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