Detachments and ON

Question 1

What are the risk factors for retinal detachment?

Answer 1

Diabetes mellitus,
Myopia,
Age,
Previous surgery for cataracts,
Eye trauma

Question 2

Presentation of retinal detachment?

Answer 2

4 F’s - Flashes, floaters, field loss and fall in vision
Painless,
Visual field defect,
RAPD,
Shaffer’s sign (tabacco dust)
Detached retina,
Retinal tear,
Loss of red reflex.

Question 3

Management of retinal detachment

Answer 3

Refer to vitreoretinal team for surgery.
Principles - remove vitreous, seal tears, tamponade the retina with gas or oil and then position patient post op.

Question 4

What are the risk factors for posterior vitreous detachment?

Answer 4

Age - over time vitreous fluid becomes less viscous and therefore doesn’t hold shape well.
Myopia - Eye has longer axial length

Question 5

Presentation of posterior vitreous detachment?

Answer 5

Sudden appearance of floaters,
Flashes of light in vision,
Blurred vision,
Cobweb appearance,
Appearance of dark curtain descending down (also means retinal detachment present)
Weiss ring on ophthalmoscopy.

Question 6

Investigations and management of posterior vitreous detachment?

Answer 6

Ix - ophthalmology review within 24 hours to rule out retinal detachment.
Management - No treatment needed. Symptoms gradually improve over 6 months.

Question 7

What are the causes of optic nerutitis?

Answer 7

Multiple sclerosis
Diabetes
Syphilis
Idiopathic

Question 8

Presentation of optic neuritis

Answer 8

Unilateral loss in VA over hours-days,
Poor colour vision,
Pain worse on eye movement,
RAPD,
Central scotoma (enlarged blind spot)

Question 9

Investigations and management of optic nerutis?

Answer 9

Ix - MRI of brain with gadolinium contrast,
Rx - High dose steroids (although uncommon to use them as mostly recovers on its own spontaneously)