Muhamad Na'im B Ab Razak (jacknaim) is a fresh graduate Muslim Doctor from Universiti Sains Malaysia and waiting for the enrollment into the housemanship program. Ambitious in pursuing master program in emergency and traumatology medicine and loves to spent his free time joining humanitarian missions, writing and speaks as an amateur public speaker in motivation and comparative religion. [HOME]

OSCE pro III series 15


Answers



1)Two abnormalities observed
-Cherry red spot
-Ground glass retina (notice the pale area at the center)


*Other abnormality in fundus examination of CRAO includes emboli (20% of the patient) and in BRAO includes whitening of retina along the distribution of occluded vessel and Boxcar segmentation



2)Acute Central Retinal Artery Occlusion



3)Relative afferent pupillary defect (RAPD)




4)Positive RAPD (paradoxical dilatation of the pupil when a light is shined from the unaffected eye to the affected eye)


5)Immediate management
-Rapid detection and treatment of visual loss


a)Immediate lowering of IOP
I.Ocular massage (5-15 seconds, repeat few times)
II.Anterior chamber paracentesis (if visual loss less than 24 hour)


b) medication like carbonic anhydrase inhibitors (Acetazolamide), Beta blocker (timolol eye drop)


-Thorough investigation for the cause of visual loss