Retinal Detachment (1*)

Question 1

What occurs here?

What are its risk factors?

Answer 1

➊ Retina separates from the vascularised choroid layer, usually due to a tear, which allows vitreous fluid to escape behind and fill the space between the layers

➋ * Trauma
* Posterior vitreous detachment
* Diabetic retinopathy
* Older age
* FHx

N.B. A viterious detachment won’t present with visual loss, but retinal detachment will.

Question 2

How does the vision loss present?

What else does it present with?

Answer 2

➊ Sudden painless and progressive vision loss - Usually starts peripherally and progresses towards the centre as the tears extends i.e. like a curtain

➋ • Floaters
• Flashes
• Blurred vision

Question 3

How can the Retinal tear be managed?

How can the Retinal detachment itself be managed?

Answer 3

➊ Laser therapy or Cryotherapy, which creates adhesions between the retina and choroid

➋ • Vitrectomy – Vitreous attached to the retinal tear is removed, and a gas or oil bubble is added to span and close the tear until a scar forms
• Scleral buckling - Silicone ‘buckle’ is placed on the scleral surface. This indents the outer eye to make contact with the detached retina.
• Pneumatic retinopexy – Small, expansile gas bubble is injected into the vitreous in the right area to flatten the detached retina against the choroid