Retinal Detachment

Question 1

What is retinal detachment?

Answer 1

Separation of the neurosensory retina from the underlying retinal pigment epithelium, leading to vision loss.

Question 2

What are the types of retinal detachment?

Answer 2

Rhegmatogenous, tractional, and exudative (serous).

Question 3

What is rhegmatogenous retinal detachment?

Answer 3

Detachment caused by a retinal tear, allowing vitreous fluid to accumulate underneath the retina.

Question 4

What is tractional retinal detachment?

Answer 4

Detachment caused by fibrous or vascular tissue pulling on the retina, often seen in proliferative diabetic retinopathy.

Question 5

What is exudative retinal detachment?

Answer 5

Detachment caused by fluid accumulation under the retina without a tear, often due to inflammation or tumours.

Question 6

What are the common symptoms of retinal detachment?

Answer 6

Sudden onset of floaters, flashes of light (photopsia), and a shadow or curtain over the visual field.

Question 7

What are the risk factors for retinal detachment?

Answer 7

High myopia, trauma, prior eye surgery, family history, and diabetes.

Question 8

What is the pathophysiology of rhegmatogenous retinal detachment?

Answer 8

A retinal tear allows vitreous humour to leak under the retina, separating it from the pigment epithelium.

Question 9

What are the clinical signs of retinal detachment?

Answer 9

Reduced red reflex, retinal elevation on fundoscopy, and retinal tears or holes.

Question 10

What are the investigations for suspected retinal detachment?

Answer 10

Fundoscopy, optical coherence tomography (OCT), and B-scan ultrasonography if the retina is not visible.

Question 11

What is the urgency of treating retinal detachment?

Answer 11

Retinal detachment is an ophthalmic emergency requiring urgent referral to prevent permanent vision loss.

Question 12

What are the differential diagnoses for retinal detachment?

Answer 12

Posterior vitreous detachment, vitreous haemorrhage, and central retinal vein occlusion.

Question 13

What is the conservative management for retinal detachment?

Answer 13

There is no conservative management; urgent surgical intervention is required.

Question 14

What are the surgical options for retinal detachment?

Answer 14

Pneumatic retinopexy, scleral buckle, and pars plana vitrectomy.

Question 15

What is pneumatic retinopexy?

Answer 15

A gas bubble is injected into the vitreous to press the retina back into place, used for simple detachments.

Question 16

What is a scleral buckle?

Answer 16

A silicone band is placed around the eye to indent the sclera and reduce traction on the retina.

Question 17

What is pars plana vitrectomy?

Answer 17

Surgical removal of the vitreous gel to relieve traction and allow reattachment of the retina.

Question 18

What are the complications of untreated retinal detachment?

Answer 18

Permanent vision loss, retinal scarring, or proliferative vitreoretinopathy.

Question 19

What is proliferative vitreoretinopathy (PVR)?

Answer 19

A complication where scar tissue forms on the retinal surface, causing traction and redetachment.

Question 20

What is the prognosis for treated retinal detachment?

Answer 20

With prompt treatment, most patients recover good vision; however, delays can result in worse outcomes.

Question 21

What lifestyle advice is given to patients at risk of retinal detachment?

Answer 21

Avoid activities that increase eye trauma risk and seek immediate care for new floaters or flashes.

Question 22

What are floaters, and why do they occur in retinal detachment?

Answer 22

Floaters are shadows cast by vitreous debris, often caused by posterior vitreous detachment or retinal tear.

Question 23

What is the role of laser photocoagulation in retinal detachment?

Answer 23

It is used to seal retinal tears and prevent progression to detachment.

Question 24

What systemic conditions increase the risk of retinal detachment?

Answer 24

Diabetes, inflammatory conditions, and connective tissue disorders like Marfan syndrome.

Question 25

Why are regular eye exams important for high-risk individuals?

Answer 25

Early detection of retinal tears or other issues can prevent progression to detachment.