Retinal detachment Flashcards

1
Q

Risk factors for for retinal detachment

A

Myopes (short sightedness)
Post cataract surgery
Ocular trauma - may be latent period
Acceleration/deceleration injuries
Male>female
Increasing age
Prev history of retinal break or detachment
FH
Proliferative diabetic retinopathy
Uveitis/scleritis
Maliganncy

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1
Q

Risk factors for for retinal detachment

A

Myopes (short sightedness)
Post cataract surgery
Ocular trauma
Acceleration/deceleration injuries
Male>female
Increasing age
Chinese and east asians > Indians and south asians > caucasians > black african

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2
Q

Types of retinal detachment

A

Rhegmatogenous
Tractional
Exudative

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3
Q

What is teh commonest form of retinal detachment?

A

Rhegmatogenous

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4
Q

WHat is retinal detachment?

A

separation of the inner neurosensory retina from underlying retinal pigment epithelium
Allowes liquified vitreous fluid to accumulate in subretinal space

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5
Q

When does retinal detahcment end in vision loss?

A

If detahcment extends to the macula

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6
Q

What often precedes retinal detachment?

A

Vitreoretinal traction -> retinal tears or breaks
50%

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7
Q

What is posterior vitreous detachment? Who has it and what does it increase the chance of?

A

Vitreous fluid shrinks and seperates from the retina - normal ageing process
by 80 86% of ppl have partial or complete
Increases chance of retinal tears

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8
Q

What is rhegmatogenous retinal detachment?

A

Commonest
Vitreous shrinks and partly seperates from retinal surface
-> retinal break or tear
Allows fluid into subretinal space
Retinal detachment

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9
Q

Exudative retinal detachment

A

Leakage of fluid into subretinal space
Due to inflam conditions eg uveitis, or malignancy eg choroidal melanoma

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10
Q

Tractional retinal detahcment what is?

A

Proliferative diabetic retinopathy - abnoraml vasculature -> contraction of vitreous
No retinal break

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11
Q

Which type of retinal detahcment is ass with proliferative diabetic retinopathy?

A

Tractional

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12
Q

Why is myopia a risk for retinal detacchment?

A

Peripheral retina is thinned and more likely to ttear

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13
Q

Symptoms of retinal detachment?

A

New onset floaters,
flashes
painless and progressive visual field loss- dark curtain or shadow
Reduction in visual acuity, blurred or distorted vision

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14
Q

What examine for in retinal detahcment

A

Reduced visual acuity
Peripheral field loss
RAPD
Asymmetric red reflex, vitreous opacities
Pale, opaque and wrinkled retinal folds
White pupillary reflex or strabismus in infants

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15
Q

INvestigation for retinal detachemnt

A

Snellen chart
Confrontational fields test
Swinging light test
Fundoscopy

16
Q

Causes of flashes

A

Post vitreous detachment
Migraine
Postural hypotension
Optic nerve pathology eg neuritis
TIA
Choroidal tumours
Drugs eg chloroquine

16
Q

Causes of flashes

A

Post vitreous detachment
Migraine
Postural hypotension
Optic nerve pathology eg neuritis
TIA
Choroidal tumours
Drugs eg chloroquine

17
Q

Causes of floaters

A

Post vitreous detachment
Myopia
Vitreous haemorrhage
Uveitis

18
Q

Management of retinal tears or breaks are treated by

A

laser or cryptotherapy

19
Q

Detachment surgical treatments

A

Vitrectomy - removes vitreous relieving traction
Scleral buckling - close off break, buckle placed over scleral surface
Pneumatic retinopexy - gas bubble injected into vitreous cavity