Retinal detachment Flashcards
define retinal detachment
where the retina separates from the choroid underneath
what usually causes retinal detachment
a retinal tear
-this allows vitreous fluid to get under the retina and fill the space between the retina and choroid
why is retinal detachment a sight-threatening emergency
the outer retina relises on the blood vessels of the choriod for blood supply
-without them it would become ischaemia and vision could be lost
risk factors for retinal detachment 6
posterior vitruous detachment
diabetic retinopathy
trauma to the eye
retinal malignancy
older age
FHx
syx of retinal detachment 4
PAINLESS
peripheral vision loss
-is often sudden and like a shadow coming across the vision
blurred or distorted vision
FLASHES AND FLOATERS
immediate Management of retinal detachment 1
patients presenting with painless flashes and floaters
-urgent referral to ophthalmologist to assess for retinal tears and detachment
sx on retinal detachment 2
relative afferent pupillary defect
-if optic nerve is involved
fundoscopy
-red reflex is lost and retinal folds appear pale or opaque (if break is small can appear normal)
management of retinal tears 2
aim:-create adhesion between retina and choroid to prevent detachment
can use:
-laser therapy
-cyrotherapy
management of retinal detachment 3
aim: reattach retina and reduce any traction or pressure that may cause retina to detach again
options:
-vitrectomy (remove relevant parts of vitreous body and replace with oil or gas)
-scleral buckling (silicone buckle to put pressure on slcera so the choroid moves into contact with the detached retina
-pneumatic retinopexy-injecting gas bubbles into vitreous body - create pressure that flattens retina against choroid
what does new onset flashes and floaters in someones vision suggest
indicate pigment cells entering the vitreous space or traction on the retina
