Question 1

Retinal Detachment | Repair and Surgery

Accepted Answer

A retinal detachment occurs when the retina's layers separate. Any portion of the retina that is detached cannot send visual signals to the brain. If left untreated, retinal detachment can cause devastating damage to an individual's vision. Retinal detachment is considered an ocular emergency that requires immediate medical attention.

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Question 2

Macular Hole | Repair and Surgery

Accepted Answer

The Macula is the portion of the retina responsible for detailed central vision. As we age, the vitreous inside the eye can shrink and pull on the retina, creating a hole in the macula. In its early stages, a macular hole can cause a slight distortion or blurriness in the central vision. Reading, and performing other routine tasks, such as driving, may become difficult. If the condition progresses, patients will experience a loss of central vision. If left untreated, the vision loss from the macular hole can be permanent.

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Question 3

Epiretinal Membrane | Monitoring and Surgery

Accepted Answer

The macula is the area of the retina that is responsible for clear vision. As a person ages, the vitreous inside of the eye begins to shrink. When this occurs in the macular area, the retina initiates a healing response with a migration of cells found within the retina itself. These cells form a thin layer of scar tissue known as a macular pucker or epiretinal membrane.

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Question 4

Vitreomacular Traction Syndrome | Monitoring and Surgery

Accepted Answer

A Vitrectomy is a procedure that treats disorders of the retina and vitreous. Vitrectomy refers to the removal of the vitreous, the clear, gel-like substance that fills the centre of the eye. An eye care professional may recommend vitrectomy surgery to treat eye problems such as, Diabetic retinopathy, Retinal detachments, Macular holes, Epiretinal membranes, also called macular puckers, bleeding inside the eye, Vitreomacular traction syndrome, which is when the vitreous is pulling or tugging the retina from its normal position, infection inside the eye, or to remove small pieces of a cataract left in the eye after cataract surgery. Before the procedure begins, local anesthesia and a mild sedative are administered for comfort and to keep the eye from moving. During the procedure, the surgeon inserts microsurgical instruments through tiny incisions made in the sclera, commonly known as the white of the eye. As the vitreous is removed, it is replaced with clear fluid, filtered air, gas bubble, or silicone oil. The fluid or gas is absorbed into the body over time and replaced by your natural eye fluid. If silicone oil is used, it does not reabsorb and is commonly removed in a few months following the procedure. Vitrectomy surgery is often performed in conjunction with other procedures, such as retinal detachment repair, macular hole surgery, and macular membrane peel. The length of the surgery depends on whether additional procedures are required, and the overall health of the eye.

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Question 5

Posterior Vitreous Detachment | Evaluation and Care

Accepted Answer

As we age, the vitreous inside the eye tends to shrink and may eventually separate from the inside surface of the eye. This is called a posterior vitreous detachment or PVD. When the vitreous pulls free from the eye, it is often accompanied by flashes of light and the appearance of tiny black spots in the vision. In general PVDs are not dangerous, but in certain cases they can lead to more serious conditions. If left untreated, these conditions can lead to vision loss and may also lead to blindness. It is suggested that anyone with symptoms of a posterior vitreous detachment should have an eye examination immediately to make sure that a more serious problem is not present. Ask us if you have questions about a posterior vitreous detachment.

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Question 6

Retinal Tear/Hole | Laser and Cryotherapy

Accepted Answer

Over the course of an individual's lifetime, the vitreous inside of the eye shrinks. As it continues to shrink, a small portion of retinal tissue may be torn off of the retina, leading to a retinal hole. You might see floaters or dark patches in your vision, or you may not experience any symptoms at all. This condition requires routine check-ups with your eye-care professional. If left untreated, retinal holes can lead to severe damage to your vision.

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Question 7

Floaters | Assessment and Management

Accepted Answer

Small specks or clouds moving in your field of vision are called floaters. Most floaters are not dangerous and are caused by tiny pieces of tissue inside of the eye. When light hits these pieces of tissue it creates shadows on the retina, that appear to float across your field of vision. It may appear that these specks are on the front surface of your eye, but they are actually inside. In most cases floaters are no cause for alarm and no treatment is necessary, however a sudden increase in new floaters may indicate a problem and an eye examination is recommended if this occurs.

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Question 8

Age-Related Macular Degeneration | Dry and Wet

Accepted Answer

Dry

The most common form of age related macular degeneration is dry form, or dry AMD, which affects up to 90 percent of AMD patients. Dry AMD can cause damage to the retina in the back of the eye which can lead to vision loss. In the early stages of dry AMD, tiny deposits called drusen start appearing within the retina. These drusen may be so insignificant that you don’t experience any symptoms or vision loss. However, if dry AMD progresses, the drusen can continue to grow in size and number. Over time, this may cause a small dark spot in your central vision, causing problems while reading or driving at night. Drusen alone are not proof of macular degeneration, but they are an important warning sign. As dry AMD progresses, it can turn into the more severe form called wet AMD. This is why it is important to monitor your condition with routine eye examinations. Talk with us today to learn more about AMD and how to preserve your vision.

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Wet

Over time, dry AMD can progress to the more serious form of age related macular degeneration, called wet AMD. Wet AMD can progress rapidly, leading to severe vision problems and permanent vision loss in the affected eye. With wet AMD, abnormal blood vessels begin to develop underneath the retina in the back of the eye. These abnormal blood vessels are unusually delicate, and may bleed or leak fluid. This fluid builds up beneath the retina, causing it to bulge or lift up from the back of the eye. As a result, the eye becomes damaged, causing vision loss to your central vision. Wet AMD doesn't always affect central vision the same way. Some patients notice blurry or distorted central vision, while others might experience a gray spot. Others develop blind spots in the center of their vision. Patients with wet AMD may experience one, or a combination of any of these symptoms. Vision loss from wet AMD is permanent, but if caught early, treatments can reduce the damage to the eye and decrease the severity of vision loss. This is why ongoing care is critical. We will monitor your condition with routine eye examinations and find the best treatment plan for you. Talk with us today to learn more about AMD and how to preserve your vision.

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Question 9

Diabetic Retinopathy | Management and Laser

Accepted Answer

Diabetic retinopathy is a diabetes-related eye condition caused by long-term high blood sugar levels that damage the small blood vessels of the retina. It can lead to vision impairment or blindness if not detected and treated early. The condition progresses from non-proliferative diabetic retinopathy (NPDR), characterized by microaneurysms and retinal haemorrhages, to proliferative diabetic retinopathy (PDR), where abnormal new blood vessels grow and may bleed or cause retinal detachments.

Management focuses on tight control of blood glucose, blood pressure, and cholesterol, along with regular eye examinations. Early stages may only require observation and systemic control. Advanced disease may require medical intervention.

Laser treatment (photocoagulation) is used to prevent vision loss by sealing leaking blood vessels and reducing retinal ischemia. Focal or grid laser is used for diabetic macular oedema, while panretinal photocoagulation (PRP) is used in proliferative disease to regress abnormal new vessels and reduce the risk of severe vision loss.

NPDR: 
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Question 10

Vein and Arterial Occlusions

Accepted Answer

Retinal vein and arterial occlusions are vascular disorders of the eye that result from impaired blood flow in the retinal circulation, leading to sudden, painless vision loss.

Retinal vein occlusion (RVO) occurs due to blockage of retinal veins, commonly associated with hypertension, diabetes, glaucoma, and hyperlipidemia. It presents as central (CRVO) or branch (BRVO) vein occlusion, causing retinal haemorrhages, oedema and ischemia.

Management and care include controlling systemic risk factors, regular monitoring, and treatment of complications such as macular oedema and neovascularization. Intravitreal anti-VEGF injections, corticosteroids, and laser photocoagulation may be used depending on severity.

Retinal arterial occlusion (RAO) is caused by sudden interruption of arterial blood supply, often due to emboli or thrombosis, and is an ophthalmic emergency. It presents as central (CRAO) or branch (BRAO) arterial occlusion with profound, sudden vision loss.

Management and care focus on urgent referral, attempts to restore blood flow in the acute phase, and systemic evaluation for cardiovascular and carotid disease. Long-term care includes managing underlying risk factors and close ophthalmic follow-up to monitor for complications such as neovascularization.

Vein Occlusion: 
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Question 11

Vascular and Choroidal Pathologies | Dry and Wet

Accepted Answer

Vascular and choroidal pathologies of the eye involve disorders of the retinal and choroidal blood supply, which are essential for maintaining retinal function and vision. These conditions can lead to visual impairment due to ischemia, leakage, or abnormal blood vessel growth.

Vascular pathologies include retinal vein and arterial occlusions, diabetic retinopathy, and hypertensive retinopathy. They are characterized by impaired blood flow, haemorrhages, oedema or neovascularization, and are often associated with systemic diseases such as diabetes, hypertension, and atherosclerosis.

Choroidal pathologies affect the choroid, the vascular layer supplying the outer retina, and include conditions such as choroidal neovascularization, central serous chorioretinopathy, choroiditis, and choroidal tumours. These disorders may cause retinal detachments, fluid accumulation or degeneration of retinal tissues.

Early detection, systemic risk factor control, and appropriate ophthalmic management are essential to prevent permanent vision loss in both vascular and choroidal diseases.

Question 12

Choroidal Osteoma | Monitoring

Accepted Answer

Choroidal osteoma is a rare and benign ossifying tumour of the choroid, typically occurring in young adults and more commonly in females. It appears as a yellow-white to orange, well-defined lesion in the posterior pole and may be unilateral or bilateral. Vision loss can occur due to retinal pigment epithelium atrophy, decalcification, or the development of choroidal neovascularization (CNV).

Management and care focus on regular monitoring, as many cases remain stable for long periods. Visual acuity assessment and retinal imaging (OCT, fundus photography, and ultrasound) are used to monitor lesion size and complications. There is no treatment to remove the osteoma itself; however, associated CNV may be treated with intravitreal anti-VEGF therapy. Long-term follow-up and patient education are essential to detect progression and preserve vision.

Question 13

Test (copy)

Accepted Answer

Test

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Vitreoretinal services

Ocular oncology services