A young patient presented with sudden painless loss of vision with systolic murmur over chest, ocular examination reveals - cherry red spot in macula with clear AC, with perception of light, diagnosis:
A i.e. Central retinal aery occlusion All the above can lead to sudden painless loss of vision, but Cherry-Red Spot is seen only in CRAO Sudden Painful Painless * Acute * Macular edema congestive * CRAO Q (central retinal aery (angle occlusion) closure) * CRVO Q (central retinal vein occlusion) glaucoma Q * Central serous retinopathy * Acute * Retinal detachment Q iridocyclitis * Exudative Age Related Macular (uveitis) Q Degeneration (ARMD) * Chemical & * Vitreous & retinal haemorrhage (eg mechanical Eale's disease) Q injury to * Optic neuritis Q eyeball * Methyl alcohol amblyopia * Subluxation or dislocation of lens Gradual Painful Painless * Corneal * Progressive pterygium ulceration * Corneal dystrophy * Chronic * Corneal degeneration simple * Cataract Q (developmental & senile) glaucoma * Chorioretinal degeneration * Chronic * Dry type - Age related macular iridocyclitis degeneration (ARMD) Q (uveitis) * Diabetic retinopathy Q * Retinitis pigmentosa Q * Optic atrophy Q * Refractive errors * Preshyopia Cherry Red Spot Macula is situated at posterior pole with its centre (foveola) being about 2 disc diameters lateral to temporal margin of disc. When retina becomes milky white due to edema, central pa of macular are shows cherry red spot due to vascular choroid shining through the thin retina of this region. Cause are:- 1. Quinine amblyopia 2. Niemann-Pick's diseaseQ 3. Metachromatic leukodystrophyQ 4. Multiple sulfatase deficiencyQ 5. Taysach's diseaseQ (GM2 gangliosidosis type 1) 6. Berlin's oedema / Commotio retinaeQ due to blunt blow on eye 7. Central Retinal Aery occlusion (CRAO)Q (not in CRVO)Q 8. Gaucher's diseaseQ, Goldberg syndrome 9. Generalized gangliosidosis (Gml gangliosidosis type 1)Q 10. Sandhoff disease (Gm2 gangliosidosis type 2, sphingolipidosis) 11. Sialidosis type 1 & 2 (cherry red spot myoclonus syndrome, sphingolipidosis) 12. Farber's disease 13. Hurler's syndrome (Mucopolysaccharidosis 1H), HallervordenSpatz disease 14. Mucopolysachharidosis VII (3 galactosidase deficiency)
Central retinal aery occlusion
Central retinal vein occlusion
Macular choroiditis with infective endocarditis
Central serous retinopathy