5 - Opth - Acute loss of vision - Posterior vitreous detachment (PVD) + Retinal detachment

Question 1

PVD - 3 features

Answer 1

usually benign, leads to increased number of floaters, degenerative changes in vitreous (liquefaction) leads to detachment from posterior retina

Question 2

In what conditions does PVD occur earlier

Answer 2

myopia, trauma, inflammation, conn tiss disease

Question 3

Complications of PVD

Answer 3

vitreous haemorrhage, retinal tear, retinal detachment

Question 4

Management of PVD

Answer 4

reassurance and advice if uncomplicated

seek help if flashes occur, decreased VA, or curtain field defect

Question 5

Retinal detachment - what happens? other causes?

more common in? where is detachment most rapid?

Answer 5

more common in myopes

detachment of vitreous may lead to retinal tear then detachment (fluid enters between retina and RPE) - can also be caused by surgery/trauma (cataracts)

detachment most rapid in superior retina due to gravity

Question 6

Presentation of retinal detachment

Answer 6

4F’s
Floaters, flashes, field loss (curtain), fall in acuity (if macula detached)

abnormal red reflex
grey ballooning retina

Question 7

management of retinal detachment

Answer 7

treat larger retinal tears with laser photocoagulation

surgical intervention fro detachment