Retinal Detachment Flashcards
What is retinal detachment?
It is defined as an ocular emergency in which the layers of the retina separate, specifically the neurosensory retina from the retinal pigment layer
What is the pathophysiological cause of retinal detachment?
There is a full-thickness retinal tear, which enables build-up of vitreous fluid behind the neurosensory retina
What seven risk factors are associated with retinal detachment?
Older Age > 40 Years Old
Male Gender
Family History
Myopia
Ocular Surgery
Eye Trauma
Diabetes Mellitus
What are the eight clincial features of retinal detachment?
Peripheral Vision Loss
Flashing Lights
Vision Floaters
Decreased Visual Acuity
Relative Afferent Pupillary Defect
Shafer’s Sign
Pale Retinal Folds
Red Reflex Loss
Describe the vision loss associated with retinal detachment
It can be described as a shadow/grey curtian moving across field of vision
What is Shafer’s sign?
It is a tobacco dust appearance of the anterior vitreous due to the migration of pigment cells through the retinal tear
What investigation is used to diagnose retinal detachment?
Ocular Ultrasound Scan
What is the feature of retinal detachment on ocular ultrasound scans?
Retinal Tear
What is the most appropriate management option in suspected retinal detachment?
Same day ophthalmology referral
What are the three surgical management options of retinal detachment?
Vitrectomy
Pneumatic Retinopexy
Scleral Buckle
What is the gold standard management option of retinal detachment?
Vitrectomy
What is vitrectomy?
It involves drainage of the vitreous and subretinal fluid, enabling the retina to lie flat against the underlying epithelium
The retinal tear is then sealed with cryotherapy or laser therapy, and the eye is then filled with an absorbing gas or silicone oil bubble to hold it in place
When is pneumatic retinopexy used to manage retinal detachment?
It is used to manage simple cases of retinal detachment
What is pneumatic retinopexy?
It involves injection of an expansile gas into the vitreous, which flattens and pushes the retina back onto the underlying epithelium
There is then administration of laser or cryotherapy to create an adhesive scar, which holds the retina into place and prevents the vitreous fluid re-entering the space behind
What is scleral buckle?
It involves administration of laser or cryotherapy to create a scar around the retinal break
A silicone band is then sutured onto the sclera, and this indents the retina to close the retinal break and relieve traction
