Retinal detachment Flashcards
What is retinal detachment?
Where the inner neurosensory retina separates from the underlying retinal pigment epithelium
What is the pathophysiology of retinal detachment?
A retinal tear allows vitreous fluid to get under the neurosensory retina and fill the space between them
Why is sight threatened in retinal detachment?
The neurosensory retina relies on the blood vessels of the choroid for its blood supply - the choroid is attached to the retinal pigment epithelium
What are the risk factors for retinal detachment?
Lattice degeneration
Posterior vitreous detachment
Trauma
Diabetic retinopathy
Retinal malignancy
Family history
What is the presentation of retinal detachment?
Dots, lines or haze
Flashes
Painless, progressive visual field loss
Blurred vision
Decreased visual acuity
Relative afferent pupillary defect
What is a relative afferent pupillary defect?
Dilation of the pupil when light is rapidly moved from the unaffected to the affected eye
What is seen on fundoscopy in retinal detachment?
Asymmetric red reflex
Vitreous opacities
Detached retinal folds - appear pale, opaque and wrinkled
What investigations are used in the diagnosis of retinal detachment?
Slip lamp examination
Fundoscopy
B-scan ultrasonography
What is B-scan ultrasonography?
An ophthalmic ultrasound which allows visualisation of the posterior segment of the eye
How is the retina reattached?
Vitrectomy
- Fixing the tear, removing the vitreous fluid and inserting gas/oil to hold the retina in place
Scleral buckling
- A ‘buckle’ is attached to the sclera, putting pressure on the sclera, and holding it in place
Pneumatic retinoplexy
- Injecting a gas bubble into the vitreous body and positioning the patient so the gas bubble pressues the separated layer back into place
