3: Retinal Detachment Flashcards
What is retinal detachment
Separation of sensory retina from the retinal pigment epithelium
What is rhegmatogenous retinal detachment
A tear in the retina enables fluid from vitreous space to enter sub-retinal space
What causes rhegmatogenous retinal detachment
trauma
What is exudative retinal detachment
retina detaches without a tear
What causes exudative retinal detachment
HTN
Vasculitis
Tumours
Macular degeneration
What is tractional retinal detachment
Pulling of the retina causing detachment
What causes tractional retinal detachment
Proliferative retinopathy
What is a risk factor for tractional retinal detachment
Myopia
What is posterior vitreous detachment
Separation of vitreous membrane from the retina
What are two signs of PVD
Floaters = peripheral vision
Flashes = temporal side of vision
Why do flashes occur
Stimulation of the retina from traction
Why do floaters occur
Vitreous condensation
What is retinal detachment
Separation of sensory retina from retinal epithelium
How does retinal detachment present clinically
Curtain coming down over vision
What is vitreous haemorrhage
Extravasion of blood into vitreous humour
How does vitreous haemorrhage present clinically
Medium - dark spots
Large - complete visual loss
What causes posterior vitreous detachment
Increases with age
What is a risk of PVD
Some people with PVD will go on to develop a retinal tear which can progress to retinal detachment
What are the 4 F’s of retinal detachment
Flashes
Floaters
Field loss
Fall in acuity
How is a field loss in retinal detachment described
Curtain coming down
If an individual has a ‘curtain coming down’ presentation what does this mean
Inferior retinal detachment
What sign will be seen
RAPD
Explain retinal detachment
Sensory retina detaches from retinal pigment epithelium. If for more than 12h there is a risk of retinal ischaemia,
What will be seen on ophthalmoscopy in retinal detachment
Grey retina will be ballooning forwards
What is first-line for retinal detachment
Rest
If superior retina is damaged, how should patient lie
Lie flat
If inferior retina is damaged, how should patient lie
Lie with head at 30’
What is second-line for retinal detachment
Laser photocoagulation therapy
What is third-line for retinal detachment
Virtectomy and gas tamponade
What is a complication of retinal detachment
Blindness