PVD and retinal detachment Flashcards
what is the vitreous boy?
The vitreous body is the gel inside the eye that maintains the structure of the eyeball and keeps the retina pressed on the choroid.
made up of collagen and water
With age it becomes less firm and less able to maintain its shape. (age as the vitreous becomes more liquefied)
what is posterior vitreous detachment?
vitreous gel comes away from the retina. It is very common, particularly in older patients.
presentation of PVD?
painless can be completely asymptomatic
Painless Spots of vision loss Floaters Flashing lights 'flashers and floaters / arc of white light and some cobwebs'
management of PVD
No treatment is necessary. Over time the symptoms will improve as the brain adjusts.
PVD and retinal detachment
Posterior vitreous detachment can predispose patients to developing retinal tears and retinal detachment. They can also present very similarly.
It is essential to exclude and assess the risk of a retinal tear or detachment with a thorough assessment of the retina. This is usually done by an optometrist or ophthalmologist.
what is retinal detachment
retina separates from the choroid underneath
usually due to a retinal tear that allows vitreous fluid to get under the retina and fill the space between the retina and the choroid.
The outer retina relies on the blood vessels of the choroid for its blood supply. This makes retinal detachment a sight-threatening emergency unless quickly recognised and treated.
retinal detachment risk factors
Posterior vitreous detachment Diabetic retinopathy Trauma to the eye Retinal malignancy Older age Family history
how does retinal detachment present?
Peripheral vision loss. This is often sudden and like a shadow coming across the vision.
Blurred or distorted vision
Flashes and floaters
management of retinal detachment / tears
detailed assessment
important to detect any retinal tears
retinal tears:
create adhesions between the retina and choroid to prevent detachment e.g through laser therapy / cryoptherapy
retinal detachement
aims re-attach the retina and reduce traction/pressure to recurrence
1) vitrectomy (remove parts of vitreous body and replace with oil / gas)
2) scleral bucking (silicone)
3) pneumatic retinopexy (gas bubble)
