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Horseshoe tears are full thickness breaks in the neurosensory retina that occur due to vitreous traction during posterior vitreous detachment and can lead to rhegmatogenous retinal detachment.⁣

They present as a flap of retinal tissue with a detached apex which always points to the posterior pole and a base attached to the retina.⁣

When there is vitreous traction and a subsequent retinal tear, the tear is attached to the vitreous as it continues to detach. The vitreous detaches in the same direction from posterior to anterior. So when the vitreous detachment hits the base of the U or V tear, it will always tear towards the ora (anteriorly). So the ‘horseshoe’ always points to the posterior pole. ⁣

Floaters occur due to vitreous debris (thickened hyaloid membrane, a Weiss ring, hemorrhage, or retinal pigment epithelium cells)⁣

Flashes of light occur due to persistent vitreous traction⁣

For treatment of retinal breaks, AAO practice patterns can be followed (Swipe to the last picture)⁣

Image from Rajan Eye Care Hospital #ophthalmology #ophthal #retina #retinaltear




SHIELD ULCER⁣

Severe forms of Vernal Keratoconjunctivitis can present with corneal manifestations which start as punctate epithelial erosions followed by macro erosions which coalesce into shield ulcers ⁣

They are characteristically present in the superior cornea (suggestive of a mechanical cause due to the large papillae) and can be sight threatening.⁣

Simple scraping of base and margins of the ulcer with removal of the inflammatory plaque like material will promote re-epithelialisation. ⁣

Image from Rajan Eye Care Hospital⁣

#ophthalmology #cornea #ophthalmobytes #ophthal

Image from Rajan Eye Care Hospital.


Vernal Conjunctivitis comes under the spectrum of allergic conjunctivitis affecting young males who present with severe itching, photophobia and a characteristic ropy discharge. ⁣ ⁣ Palpebral: Flat topped papillae in the upper tarsal conjunctiva arranged in a cobblestone pattern (as seen in the picture) ⁣ ⁣ Bulbar: Dusky red triangular congestion of bulbar conjunctiva in palpebral area, Thickening and opacification of the limbal conjunctiva with gelatinous limbal papillae⁣ ⁣ Mixed : A combination of palpebral and bulbar forms ⁣ ⁣ *Buckley coined the term “morning misery” which described the active disease state of patients with severe discomfort, blepharospasm and mucous discharge leaving them incapacitated upon awakening. ⁣ ⁣ Image from Rajan Eye Care Hospital⁣ #ophthalmology #ophthalmobytes #ophthal #conjunctivitis

 
 

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