CLINICAL APPROACH AND DIFFERENTIAL DIAGNOSIS (,contd)
Small deep haemorrhages-^ DIABETIC RETINOPATHY
and hard exudates in a long-standing diabetic
Dark oval mass - possibly related to — in middle aged —MALIGNANT MELANOMA secondary retinal patient detachment
White mass behind the pupil- in infancy-— RETINOBLASTOMA
If ophthalmoscopic examination is normal, or if optic atrophy is evident, then visual field examination is essential. Visual confrontation is useful for detecting large defects, but smaller defects require visual field charting with a Goldmann perimeter (page 10).
In interpreting the results of examination it is important to remember that the ocular system reverses the image. The nasal side of the fundus picks up the temporal image and vice versa. Damage, therefore, to the nasal side of the retina will produce a temporal visual field defect.
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