Retinal Detachment

Question 1

Describe the pathophysiology of retinal detachment: (2)

Answer 1

1) the neurosensory layer of the retina containing photoreceptors and nerves is separated from the retinal pigment epithelium
2) the neurosensory layer relies on blood vessels from the choroid and so detachment disrupts this supply, causing damage to photoreceptors

Question 2

True or false: retinal detachment is sight threatening

Answer 2

true

Question 3

Give 6 risk factors for retinal detachment:

Answer 3

1) trauma
2) thinning of the retina (lattice degeneration)
3) retinal malignancy
4) diabetic retinopathy
5) posterior vitreous detachment
6) family history

Question 4

What is the key symptom of retinal detachment?

Answer 4

painless changes to vision

Question 5

Give 3 painless changes to vision which may be seen in retinal detachment:

Answer 5

1) peripheral vision loss (described as a shadow coming across the vision)
2) blurred or distorted vision
3) flashes and floaters

Question 6

Give two treatments that aim to create adhesions between retina and choroid to treat retinal tears:

Answer 6

1) laser therapy
2) cryotherapy

Question 7

Give three treatments that aim to reattach the retina:

Answer 7

1) vitrectomy
2) scleral buckling
3) pneumatic retinopexy

Question 8

Describe vitrectomy surgery:

Answer 8

this is a keyhole surgery that removes vitreous fluid, fixing a retinal tear and then inserting gas or oil into the eye to hold the retina in place

Question 9

Describe scleral buckling surgery:

Answer 9

a silicone buckle/band is attached to the sclera, that puts pressure on the sclera and squashes the eye inwards, to connect the layers of the retina

Question 10

Describe pneumatic retinopexy:

Answer 10

the injection of a gas bubble into the vitreous body and positioning the patient so the gas bubble presses the separated layers back into place