Retinitis Pigmentosa, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions
By Kenneth Kee
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About this ebook
Retinitis pigmentosa is a form of hereditary slow degenerative disease of the retina.
Who is affected by Retinitis pigmentosa?
Retinitis pigmentosa is believed to be a genetically determined disease in which the abnormal photoreceptors or the retinitis pigment in the epithelium of the retina result in progressive loss of vision.
Initially there is night blindness due to the abnormal photreceptors (rods first, followed by cones).
This is followed by the loss of peripheral visual field known as tunnel vision which may presist for some years.
Finally the macular region is affected with loss of central vision in the later stages.
In rare cases blindness may occur in childhood.
It is a rare condition causing loss of vision.
What are the causes of Retinitis pigmentosa?
1. Genetic
There is a family history of Retinitis pigmentosa
The cause is usually in the genes and of the recessive trait.
There is a mild form of dominant trait.
Rarely it is sex linked and can be severe.
2. Degeneration
Degeneration of the retina affects the rods and cones starting with equatorial areas and then the macular region in later stages.
What are symptoms and signs of Retinitis pigmentosa?
Symptoms:
1. Loss of night vision starting in childhood.
The visual fields develop concertive contraction leading to central tubular vision.
2. Tunnel vision occurs at age of 40-50 for several years or decades
3. Loss of central vision usually at 50-60 years of age
Signs:
1. In early stage, direct opthalmoscopy show small spidery black spots in affected retina
2. Vessels are sheathed with pigments in some areas
3. Retinal vessels become attenuated (thinned)
4. Optic atrophy(cellophane maculopathy) sets in
5. Posterior subcapsular cataracts form at late stage.
6. There is associated myopia and deafness.
How is Retinitis pigmentosa diagnosed?
1. Examination of the retina by ophthalmoscopy after the pupils have been dilated may show the presence of dark pigments in the retina
2. Electroretinography (ERG) shows progressive loss of photoreceptor function
3. Visual field testing shows loss of peripheral vision
4. Fluorescein angiography shows dark pigments which establish the presence of Retinitis pigmentosa.
5. Intraocular pressure may be increased
6. Measurement of the electrical activity in the retina (electroretinogram)
7. Refraction test
8. Side vision test (visual field test) – peripheral vision is affected and tunnel vision may be present especially in the older patients
9. Slit lamp examination – may show the presence of dark pigments in the retina
10. Visual acuity testing – visual acuity may not be affected in the central area
Retinitis pigmentosa can be secondary to inflammatory disease occuring in the late stages.
What is the complication of Retinitis pigmentosa?
There is partial to complete loss of vision.
What is the treatment for Retinitis pigmentosa?
Retinitis pigmentosa has no cure.
Wearing sun glasses may help to protect the eyes from the sun.
High daily intake of 15000 IU of vitamin A palmitate may slow the disease but can cause damage to the liver.
Microchip implants into the retina can help to act as a microscopic video camera.
These artificial retinal implants are useful for treating blindness associated with Retinitis pigmentosa.
New treatments for retinitis pigmentosa include the use of DHA, which is an omega-3 fatty acid.
Gene therapy in the affected retinal cells may help in the future.
The use of stem cells to rejuvenate the retina cells is under investigation.
TABLE OF CONTENT
Introduction
Chapter 1 Retinitis Pigmentosa
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosi
Kenneth Kee
Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"
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Retinitis Pigmentosa, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions - Kenneth Kee
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