Retinal detachment Flashcards
Risk factors for for retinal detachment
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
Risk factors for for retinal detachment
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
Types of retinal detachment
Rhegmatogenous
Tractional
Exudative
What is teh commonest form of retinal detachment?
Rhegmatogenous
WHat is retinal detachment?
separation of the inner neurosensory retina from underlying retinal pigment epithelium
Allowes liquified vitreous fluid to accumulate in subretinal space
When does retinal detahcment end in vision loss?
If detahcment extends to the macula
What often precedes retinal detachment?
Vitreoretinal traction -> retinal tears or breaks
50%
What is posterior vitreous detachment? Who has it and what does it increase the chance of?
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
What is rhegmatogenous retinal detachment?
Commonest
Vitreous shrinks and partly seperates from retinal surface
-> retinal break or tear
Allows fluid into subretinal space
Retinal detachment
Exudative retinal detachment
Leakage of fluid into subretinal space
Due to inflam conditions eg uveitis, or malignancy eg choroidal melanoma
Tractional retinal detahcment what is?
Proliferative diabetic retinopathy - abnoraml vasculature -> contraction of vitreous
No retinal break
Which type of retinal detahcment is ass with proliferative diabetic retinopathy?
Tractional
Why is myopia a risk for retinal detacchment?
Peripheral retina is thinned and more likely to ttear
Symptoms of retinal detachment?
New onset floaters,
flashes
painless and progressive visual field loss- dark curtain or shadow
Reduction in visual acuity, blurred or distorted vision
What examine for in retinal detahcment
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
INvestigation for retinal detachemnt
Snellen chart
Confrontational fields test
Swinging light test
Fundoscopy
Causes of flashes
Post vitreous detachment
Migraine
Postural hypotension
Optic nerve pathology eg neuritis
TIA
Choroidal tumours
Drugs eg chloroquine
Causes of flashes
Post vitreous detachment
Migraine
Postural hypotension
Optic nerve pathology eg neuritis
TIA
Choroidal tumours
Drugs eg chloroquine
Causes of floaters
Post vitreous detachment
Myopia
Vitreous haemorrhage
Uveitis
Management of retinal tears or breaks are treated by
laser or cryptotherapy
Detachment surgical treatments
Vitrectomy - removes vitreous relieving traction
Scleral buckling - close off break, buckle placed over scleral surface
Pneumatic retinopexy - gas bubble injected into vitreous cavity
