EUSTO

APPAERENCE

PHTHISIS BULBI

ANOPHTHALMOS
MICROPTHALMOS
Microphthalmos also called microphthalmia, is a rare developmental disorder of the eye in which one or
both eyes are abnormally small.

PROPTOSIS
Proptosis is protrusion of the eyeball. (Exophthalmos)
DYSTOPIA
Orbital dystopia is when one eye is lower than the other

APPANDAGES
CHALAZION
A chalazion is an enlargement of an oil-producing gland in the eyelid.
STYLE
A stye (also called a hordeolum) is a small, red, painful lump that grows from the base of your eyelash or
under the eyelid.
ENTROPION AND ECTROPION

PTOSIS
MEIBOMITIS/BLEPHARITIS

TRICHIASIS

DYSTRICHIASIS
ROPLAS TEST
LACRIMAL SYRINGING
 CONJUNCTIVA
CONJUNCTIVA CONGESTION

CONJUCTIVAL BLEB
SUBCONJUNCTIVAL HAEMORRHAGE

Chemosis
CONJUNCTIVAL PSEUDOMEMBRANES
GIANT FORNIX SYNDROME

SUBCONJUNCTIVAL CICATRIZATION (SCARRING)

PAPPILAE AND FOLLICLES
PINGUECULA
PTERYGIUM

PHLICTEN

Small, yellow-gray, raised bumps (called phlyctenules) appear at the limbus (the area where the
conjunctiva attaches to the cornea), on the cornea, or on the conjunctiva.

Phlyctenular keratoconjunctivitis is not an infection. It is an immune reaction to bacteria that are on or

around the eyes. Some of the bacteria that trigger this disorder are staphylococci, and rarely,
tuberculosis, and Chlamydia. This disorder is more common among children.
squamous cell carcinoma of conjunctiva
Enlarged: Conjunctival intraepithelial neoplasia (CIN) with full thickness dysplasia (squamous cell
carcinoma in situ)
Conjunctival intraepithelial neoplasia (CIN) with full thickness dysplasia (squamous cell carcinoma in situ)

Symblepharon
DISCHARGE
 SCRELA
Episcleritis
Conjunctival concretions
 CORNEA
CORNEA SIZE

MICROCORNEA

Microcornea is defined as a cornea less than 10 mm in diameter.

MACRO CORNEA (Megalocornea)

Megalocornea is a condition in which there is a bilateral, non-progressive enlargement in corneal

diameter ( >13 mm in adults, >12 mm in newborns).
CORNEA SHAPE

IRREGULAR SHAPE

KERATOCONUS
KERATOGLOBUS

Keratoglobus is a rare noninflammatory corneal thinning disorder characterised by generalised thinning

and globular protrusion of the cornea.
CORNEA SURFACE

EPITHELIAL DEFECT

This image shows a corneal epithelial defect, or corneal abrasion, after the application of fluorescein
dye. The staining pattern is more visible under cobalt blue light.
CORNEA SCAR

CORNEAL ULCER

A corneal ulcer is a defect in the surface epithelium of the cornea that involves the underlying stroma.

DESCEMET FOLDS
CORNEAL NEOVASCULARIZATION

CORNEA DEGENERATION
Corneal arcus( arcus senilis)

Corneal arcus, also known as arcus senilis or gerontoxon, is a common degenerative change of the
peripheral cornea in older adults, but may be a sign of hyperlipoproteinemia in individuals under 40
years of age.
Corneal dystrophies
Corneal dystrophies are a group of rare, genetic eye disorders, caused by the build-up of
material in one or more layers of the cornea.
There are more than 20 different types of corneal dystrophies.
FUCHS DYSTROPHY

many patients with Fuchs' dystrophy, their vision is usually hazy in the morning and clears up
throughout the day.

Patients have worse vision in the morning because of the eyes being closed during the night causing a
buildup of corneal edema (because the endothelium helps keep the cornea dry and clear). During the
day, with the eyes open, the cornea becomes a little more dehydrated. Patients can be treated with
dehydrating ointments (5% NaCl) or even with a hair dryer in the earlier symptomatic stages prior to PK
KERATIC PRECIPITATES (KP)

Cellular deposits on the corneal endothelium. Acute, fresh KPs tend to be white and round, while old
KPs are usually irregular, faded and pigmented. Mutton-fat KP: large, greasy-white KPs (approximately 1
mm in diameter), which represent clusters of macrophages and epithelioid cells.
Mutton fat kps
PUNCTATE EPITHELIAL LESIONS

Slit-lamp photograph in diffuse illumination showing punctate epithelial lesions with a “stuck-on
appearance” on the cornea

BULLOUS KERATOPATHY
Fig. 1. Slit lamp examination on direct (A) and retro (B) illumination reveals large, scattered epithelial
bullae with mild corneal haze. Note the quiet conjunctiva

MICROCYSTIC (EPITHELIAL) EDEMA

HUDSON STAHLI LINE CORNEA

CORNEA OPACITY

Corneal opacity refers to scars on the cornea.

CORNEA SATURES and GRAFT

CONTACT LENS
CORNEA EDEMA

CORNEA FLUORESCEIN STAINING

This is a test that uses orange dye (fluorescein) and a blue light to detect foreign bodies in the eye. This
test can also detect damage to the cornea.
Tear film break-up time (TBUT) is a method for determining the stability of the tear film and checking
evaporative dry eye. Generally, >10 seconds is thought to be normal,(10, 11, 12) 5 to 10 seconds,
marginal, and < 5 seconds is considered low.
CORNEA SENSITIVITY

To conduct corneal sensitivity testing, approach the patient from the side and test the center and all 4
quadrants of the eye. When the cotton thread gently touches the cornea, normal subjects show a blink
reaction and can describe the sensation of touch, while patients with loss of corneal sensitivity do not
react.

Schirmer's test

is used to determine whether the eye produces enough tears to keep it moist. This test is used when a
person experiences very dry eyes or excessive watering of the eyes.
The test is performed by placing filter paper inside the lower lid of the eye. After 5 minutes, the paper is
removed and tested for its moisture content.

ANTERIOR CHAMBER
DEPTH

DEEP
Difference should be equal and greater than Cornea thickness

CELLS
FLARE
HYPHEMA
HYPOPYON

PUPIL
SHAPE

ROUND
OVAL

ECCENTRIC (not centered)

Occur in corectopia
IRREGULAR PUPIL

POLYCORIA

is a pathological condition of the eye characterized by more than one pupillary opening in the iris.

PUPIL SIZE 3mm

2 to 4 millimeters in bright light and 4 to 8 millimeters in dim light (dilated).

PUPIL REACTION TO LIGHT

Direct and consensual (normal/sluggish/absent)

AFFERENT PUPILLARY DEFECT (RAPD) (present /absent)

IRIS
SHAPE

NEOVASCULARIZATION OF THE IRIS (RUBEOSIS IRIDIS)NVI

SYNECHIAE

POSTERIOR SYNECHIAE
PERIPHERAL IRIDOTOMY
IRIS PROLAPSE
Corneal tear (black arrow) with iris prolapse (teardrop pupil) (white arrow)

LENS
NATURE

CLEAR
CATARACT
PSEUDOPHAKIA

APHAKIA
POSITION

SUBLUXATED LENS

When the lens is displaced but remains in the pupillary area, it is considered subluxated.
DISLOCATED LENS

Fundus photograph demonstrating late spontaneous IOL-capsular bag complex dislocation into the
vitreous cavity

CATARACT

GRADING
EXTRA OCLULAR MUSCLES AND SQUINT

SQUINT

PHORIA

A phoria refers to a tendency for the eyes to drift slightly out of alignment when they are not actively
focusing on an object, but they can be brought back into alignment by the brain's control of eye
muscles. It's a type of eye misalignment that is typically latent, meaning it's only noticeable when the
eyes are not actively engaged in focusing on an object, such as during relaxed viewing.

FUNDUS
MEDIA

HAZY MEDIA
CREAR MEDIA

PVD
OPTIC DISC

SIZE : 1.88 mm in height and 1.77 mm in width.

CUP-TO-DISC RATIO : LESS THAN 0.5.
PALE OPTIC DISC
papilledema
Fundus photographs show (a) a small hyperaemic swollen optic disc and no haemorrhage; and (b)
resolution of the swelling in the same optic disc, with no observable atrophy, three months later.

OPTIC NEURITIS
BLOOD VESSELS

veins are thicker than arteries, veins are darker (redder), and central reflex is more recognizable for
arteries.

KINKING OF THE VESSELS

TORTUOUS VEINS
Arteriolar Attenuation

Generalised arteriolar attenuation, pale both eyes, vascular sheathing and empty vessels

SCLEROSED VESSELS
RIGHT EYE FUNDUS IMAGE OF 58 YEARS OLD MALE WITH OLD BRVO HAVING SCLEROSED VESSELS

Vascular sheathing in idiopathic retinal vasculitis

Engorged retinal veins
Fundus photograph showing Disc edema, Tortuous and Engorged retinal veins, with superficial retinal
haemorrhages in a case of Central Retinal Vein Occlusion.

Fundus findings of slightly tortuous and engorged retinal veins at first visit. (B) After one month, the
retinal venous tortuosity and engorgement were no longer present.
Combined cilioretinal artery and central retinal vein occlusion in an otherwise 49-year-old healthy
female patient. Color fundus photography shows whitening of the retina in the distribution of the
cilioretinal artery and intraretinal hemorrhages with tortuous and engorged veins.

MACULA

FOVEAL REFLEX :is a bright pinpoint of light that is observed to move sideways or up and down in
response to movement of the opthalmoscope.

HARD AND SOFT EXUDATES

DRUSENS
COTTON WOOL SPOTS
MICROANEURYSMS
HEMORRHAGE

SUBRETINAL HEMORRHAGE
RETINA SCAR
Chorioretinal scar inferior temporal in the right eye of a middle aged patient.

RETINA ATROPHY
PIGMENT ALTERATION
Tigroid Fundus
CYSTOID MACULAR EDEMA
PIGMENT EPITHELIAL DETACHMENT
PIGMENTARY CHANGES
Primary macular pigmentary changes and atrophy of the retinal pigment epithelium.

EPIRETINAL MEMBRANE
MACULA HOLE
FTMH
FTMH
FTMH
Lamellar macula hole

ILM STRIAE
ILM striae and mild macular puckering following laser P.R.P. treatment
Internal limiting membrane (ILM) folds over the macula and mild disc hyperemia
CHERRY-RED SPOT

hyperemic optic disc with a couple of peripapillary hemorrhages, generalized arteriolar narrowing, a
cherry-red spot in the macula, and retinal whitening surrounding the fovea

VITREOUS

VITREOUS CELLS
SNOW BANKING
VITREOUS HAEMORRHAGE
ASTEROID HYALOSIS

asteroid hyalosis, showing a multiple-yellow-white, round, particles composed of calcium.

VITREOUS FLOATERS
Asteroid Hyalosis
Slit lamp photograph of a 48-year-old female patient with long-standing diabetes attending consultation
due to the sensation of moving spots in her vision.
Vitreous condensation
Very intense gelatinous condensation and detachment of the vitreous after chorioretinal inflammation.

This lattice lesion. Note the many yellow dots above the surface of the retina which are actually located
in the vitreous condensation which surrounds the pocket of liquified vitreous over the lesion.
WEISS RING

Fundus photograph with anterior shot, shows a weiss ring pulled off from the optic nerve.
Color fundus photograph of a patient with macular hole along with surrounding cuff of fluid. A Weiss
ring can be seen anteriorly in the vitreous.

SUBHYALOID HAEM

You don’t see the vessels because the bleeding is above, unlike intaretinal which one will see vessels
The left fundus showing a dome-shaped sub-ILM haemorrhage (white asterix) and a subhyaloid
haemorrhage located anterior and inferotemporal to the sub-ILM hemorrhage (orange asterix). Note the
‘double ring’ sign with the ‘inner ring’ caused by the sub-ILM bleed (blue arrows) and the ‘outer ring’ by
the subhyaloid bleed (black arrows).

RETINA DETACHMENT

Subtotal RD
Recent subtotal rhegmatogenous retinal detachment.

TOTAL RETINAL DETACHMENT

Total retinal detachment in the left eye.

subclinical retinal detachment

two tiny non tractional round holes which had produced a small subclinical retinal detachment at 7:00
o’clock in this eye.

Rhegmatogenous Retinal Detachment

bullous rhegmatogenous retinal detachment.
TRACTIONAL RETINAL DETACHMENT
diabetic patient showing extensive TRD with PDR.
type 2 diabetic with post PRP macular extensive tractional retinal detachment involving macula.
Wide field view of PDR with TRD

Exudative Retinal Detachment

Fundus photograph of the right eye. Left: bullous exudative retinal detachment at postpartum day 1 in
HELLP syndrome. Right: fundus photograph of the same eye at postpartum day 16.

Retinal tears

retinal detachment with multiple retinal tears and vitreous hemorrhage present.
H orseshoe Retinal Tear With Bridging Blood Vessel

LATTICE DEGENERATION
Lattice degeneration in the peripheral retina (arrows).
Wide field Montage of RE of a 46 year male with Lattice degeneration
Photograph of the peripheral retina demonstrates an area of lattice degeneration. Note the retinal
thinning, which is characterized by a color change. There are also pigment clumps and crosshatching of
sclerotic vessels, two features commonly observed in lattice degeneration.
A patient of inferior retinal detachment with lattice inferiorly.

Atrophic retina holes

Lattice degeneration with large atrophic hole (stereo pair B).
Atrophic Holes in Lattice Lesion: two atrophic holes in a lattice lesion led to a clinical retinal detachment
Horseshoe Tear
Horseshoe Tear With Detachment

Operculated hole
Operculated hole occurs due to the vitreous traction over the flap of the retinal tear, resulting in the
separation of the flap (suspended within the posterior hyaloid above the retinal surface). In this case,
the symptomatic hole was treated using laser photocoagulation.
Operculated hole-treated
Operculated hole-4 month after treatment
58-year-old woman with an operculated hole and CHRPE in the right eye.

retinal dialysis
Pseudocolor fundus photograph of the right eye showing mild vitreous hemorrhage, normal appearing
nerve and macula, and a retinal dialysis in the nasal periphery with adjacent retinal commotio and
intraretinal hemorrhages.
Ultra-wide fundus photograph of a 64-year-old woman with a retinal dialysis occurred after trauma.

GIANT RETINAL TEAR

a) Ultra-widefield photograph demonstrating giant retinal tear (GRT) with macula involving retinal
detachment and (b) high-magnification view of the edge (arrows) of the GRT extending for
approximately 5 to 6 clock hours.
Wide-field fundus photograph of the left eye showing a superotemporal giant retinal tear (GRT). A
characteristic feature of this type of retinal detachment is posterior folding of the detached retina.
Repositioning of the fold is facilitated by intra-operative perfluorocarbon liquid (PFCL) tamponade. Intra-
or post-operative slippage can occur when the PFCL is exchanged for gas or, more rarely, silicone oil. An
effective alternative is short-term post-operative tamponade with PFCL, which minimises the risk of
retinal slippage

Giant Retinal Tear of the Right eye.

COMMOTIO RETINAE
Extensive commotio retinae involving peripheral retina.
Color fundus photograph, left eye. The media are hazy due to vitreous hemorrhage. There is pre-retinal
hemorrhage along the arcades (red arrow). There is a choroidal rupture involving the fovea (yellow
arrow) with surrounding macular and peripheral commotio (white arrows).

Color fundus photograph of a 24-year-old woman who was hit by a volleyball in her right eye. This
caused whitening of the lower peripheral retina (Berlin's edema) i.e. commotio retinae.

CHOROIDAL MELANOMA
CHOROIDAL NEVUS
 DISEASES
CAT SCRATCH DISEASE (BY BARTONELLA HENSELAE)
BULLS EYE MACULOPATHY
SYNCHYSIS SCINTILLANS