Rings-lines-dots and spots and other things in ophthalmology.pptx

Rings-lines-dots and spots and other things in ophthalmology

1. Rings, Lines, Dots, Spots and other things in Ophthalmology Dr. Riyad Banayot

2. What do you see? Arcus Senilis Corneal grey ring-shaped degeneration made of lipids There are no symptoms, and doesn’t cause blurring of vision so it doesn’t need any treatments seen in old age patients

3. What do you see? Corneal rust ring A small, reddish-brown, circular Opacity in the Cornea after the metalic foreign body sticks in cornea.

4. What do you see? Coats’ White Ring Fine iron deposits in the bowman’s layer remaining after a corneal foreign body

5. What do you see? Hoarfrost ring Pseudoexfoliation (Whitish-gray protein) deposits on the anterior lens capsule.

6. What do you see? Zentmayer ring (Scheie stripe) A circle of pigment seen on the posterior lens capsule at the insertion of the lens zonule

7. What do you see? Double Ring Sign IN optic nerve hypoplasia, optic disc is often pale or gray and smaller than normal. Optic discs often present with double ring sign yellow to white ring around the disc. The white arrow indicates the optic nerve. The black arrow indicates the double-ring sign.

8. What do you see? Bitot’s Spots A buildup of keratin located superficially in the conjunctiva. they are oval, triangular or irregular in shape. Seen in Vitamin A deficiency

9. What do you see? Golden ring Seen within the lens is evidence of a good, successful hydro delineation during cataract surgery.

10. What do you see? Brushfield Spots Whitish grey spot in peripheral iris due to aggregation of connective tissue These spots are normal in children ( Kunkmann -Wolffian bodies), but are also a feature of Down syndrome

11. What do you see? Fuch’s Spot Pigmented (RPE hyperplasia) macular lesions Seen in pathological myopia

12. What do you see? Krachmer Spots Sub-epithelia infiltrates on the donor cornea, with deeper oedema and infiltrative pacification Seen in corneal stromal graft rejection

13. What do you see? Leopard spot Patchy subretinal infiltrate appears in reticular cell Seen in carcinoma, CSR and other conditions of retina

14. What do you see? Histo Spots A small circular punched-out spot in the retina at a site where spores of the fungus histoplasma ( histo ) seeded in the eye. Histo spots may be multiple, found in both eyes, and scattered throughout the retina. Can be seen in presumed ocular histoplasmosis syndrome (POHS).

15. What do you see? Cotton-Wool Spots Fluffy white patches Ischemic disruption of nerve axons Seen in in type 2 diabetes, high blood pressure, HIV, leukemia and lymphoma, Immune and inflammatory response deficiency

16. What do you see? Cherry red spot A reddish area at the center of the macula, surrounded by retinal opacification Seen in central retinal artery occlusion Other causes

17. What do you see? Cream colored spot – Birdshot vitiliginous chorioretinitis C haracterized by multiple, cream-colored lesions in the retina and choroid, often clustered around the optic disc, and associated with HLA-A29. 

18. What do you see? Koplik spots Characterized as clustered, white lesions on the buccal mucosa (opposite the lower 1st & 2nd molars), conjunctiva pathognomonic for measles.

19. What do you see? Gunn's dots tiny white dots sometimes visible overlying the large vessels near the optic nerve or the nerve fiber layers. no pathologic significance.

20. What do you see? Cattle truck ( boxcarring ) appearance The blood column appears segmented or "box-like" due to slow, sluggish blood flow. 

21. What do you see? Roth spots Hemorrhages with white or pale centers they can be composed of coagulated fibrin including platelets, focal ischemia, inflammatory infiltrate, infectious organisms, or neoplastic cells Seen in subacute bacterial endocarditis, leukemia, and anemia

22. What do you see? Elschnig spot Black spots surrounded by bright yellow or red halos seen on the retina Due to changes in the retinal pigment epithelium from non-perfused areas of the choriocapillaris in hypertension.

23. What do you see? Fischer- Khunt spot Senile scleral plaque, bilateral oval, dark-greyish areas located close to the insertion of the horizontal rectus muscles Seen in old age

24. What do you see? Vossius ring Iris pigment on anterior lens capsule Seen in blunt trauma to the eye

25. What do you see? Weiss ring Ring-shaped floater Seen in posterior vitreous detachment (PVD)

26. What do you see? Soemmering’s ring Posterior lens capsule opacification. I ncomplete ring of milky white material Seen in traumatic cataract

27. What do you see? Stocker’s line Iron deposition in a line in corneal epithelium Seen in pterygium

28. What do you see? Ferry’s line Corneal epithelial iron line at the edge of filtering blebs

29. What do you see? Fingerprint lines / map-dot-fingerprint dystrophy Epithelial basement membrane dystrophy Asymptomatic

30. What do you see? Hudson-Stahli’s line I ron deposition  line in the corneal epithelium, Seen in the junction between the middle and lower third of the cornea. 

31. What do you see? Krukenberg’s spindle A pattern formed on the inner surface of the cornea by pigmented iris cells that are deposited as a result of the currents of the aqueous humor Shedding occurs during the mechanical rubbing of the posterior pigment layer of the iris with the zonules Associated with “classic” or primary pigment dispersion syndrome (PDS) and pigmentary glaucoma.

32. What do you see? Kayser-Fleischer rings Copper deposition in Descemet membrane Seen in Wilson disease

33. What do you see? Paton’s line Circumferential retinal fold Seen in papilledema

34. What do you see? Ring scotoma in retinitis pigmentosa

35. What do you see? Fleischer rings Iron deposition around the base of a cone Seen in Keratoconus

36. What do you see? Horner- Trantas dots / spots F ocal white limbal dots consisting of degenerated epithelial cells and eosinophils on top of nodules Seen in Vernal Keratoconjunctivitis

37. What do you see? Mittendorf’s dots A small circular opacity on the posterior lens capsule. Embryological remnant of the hyaloid artery

38. What do you see? Kaye’s dots W hite punctate epithelial opacities located in the epithelium anterior to the suture line of a corneal graft R epresent epithelial cells in various stages of degeneration NOT visually significant and do not bear any clinical significance.

39. What do you se? Arlt’s line H orizontal, linear scar in conjunctiva Seen in Trachoma

40. What do you see? Herbert’s pits Acute trachoma is characterized by a follicular conjunctivitis. Follicles may also appear at the limbus Healed follicles form the pathognomonic cicatrial scars

41. What do you see? Vogt’s striae / line Whitish lines in the stroma and Descemet's membrane of the cornea Seen in Keratoconus

42. What do you see? White lines of Vogt Sheathed or sclerosed vessels seen in Lattice degeneration of the retina. Lattice degeneration of the retina is characterized by the presence of lattice lines created by fibrosed blood vessels.

43. What do you see? Haab striae Curvilinear breaks in Descemet’s membrane Seen in congenital glaucoma

44. What do you see? Foster- Fuch’s spot A raised, pigmented, circular scar on the retina that develops after a subretinal hemorrhage has been absorbed A ssociated with moderate to high myopia

45. What do you see? Wessley ring Sterile, corneal intrastromal reactions resulting from an immune response to foreign antigens

46. What do you see? Khodadoust line Also known as an endothelial rejection line A line of inflammatory precipitates on the endothelial surface. Starting at the periphery and progressing towards the center.  A medical sign indicating corneal graft rejection

47. Yellow spot = Macula Lutea Yellow spot = Macula Lutea Located in the center of the retina and responsible for sharp, detailed vision, including color vision and fine details.  The yellow color is due to the presence of high levels of the carotenoid pigments lutein and zeaxanthin

48. What do you see? Blind spot = optic disc A normal area in the visual field where the optic nerve exits the eye, lacking light-sensitive cells and resulting in a lack of vision at that specific point. 

49. What do you see? Pin-cushion scotoma – metamorphopsia straight lines appear bowed inward, towards the center of the visual field, like a pincushion Associated with conditions such as: Macular holes or Macular degeneration

50. What do you see? Barrel distortion straight lines appear to curve outwards, resembling the bulge of a barrel Occurs as a result of  a lens at full zoom

51. What do you see? Ring of sommering A ring-like structure formed by retained equatorial lens epithelial cells that proliferate and form new cortical fibers between the posterior capsule and the edges of the anterior capsule remnant Seen after cataract surgery

52. What do you see? Rosette-shaped cataract characterized by radial, spoke-like opacities in the lens Associated with blunt or penetrating eye trauma, electric shock, or exposure to radiation. 

53. What do you see? Snow flakes cataract Characterized by white, snowflake-shaped opacities in the lens, A ssociated with uncontrolled diabetes, particularly type 1

54. What do you see? Blue dot cataract Developmental cataract characterized by small, blue-white opacities in the lens Appearing during childhood or at birth Patients have well-preserved vision, some may experience mild blurring or other visual problems, especially as the opacities progress. 

55. What do you see? Corneal ring infiltrates – Ring keratitis Ring-shaped stromal infiltrates, typically circumferential to the limbus (the edge of the cornea), often leaving a clear zone in the center.  strongly associated with acanthamoeba keratitis

56. What do you see? SL: Schwalbe’s line Schwalbe’s line L ocated at the peripheral end of the cornea, where Descemet's membrane (the innermost layer of the cornea) ends, and it marks the beginning of the trabecular meshwork a narrow, white or translucent line

57. What do you see? Sampaolesi's Line Pigment deposited anterior to Schwalbe's line Can be idiopathic, or sometimes this line indicate pseudoexfoliation (PXF) syndrome, pigment dispersion syndrome glaucoma

58. What do you see? Dot / blot hemorrhages Due to rupture of wall of capillary or microaneurysm, giving rise to intra retinal hemorrhage. If the hemorrhage is deep (i.e. in the inner layer of Outer Plexiform Layer) it is usually is round or oval (dot/ blot hemorrhage)

59. What do you see? Tunnel vision A condition where a person's ability to see objects outside their direct line of sight is significantly reduced or lost Eye Conditions:  Glaucoma, retinitis pigmentosa, diabetic retinopathy, and retinal detachment Brain Damage:  Damage to the brain, including stroke Other Factors:  Certain medications, extreme stress or anxiety, and even high accelerations can temporarily cause a similar effect.

60. What do you see? Candle wax dripping A ppearing as scattered whitish-yellow perivascular retinal exudates ( vascular sheathing) along the retinal veins A characteristic sign of retinal vasculitis in ocular sarcoidosis

61. What do you see? Snowball and Snow Banking Snowball : Vitreous condensations Snow Banking: P ars plana exudates Seen in parsplanitis