Retinal detachment

Question 1

What is retinal detachment (RD)?

Answer 1

Separation of the neurosensory retina from the retinal pigment epithelium (RPE) by sub-retinal fluid.

Question 2

Why is RD considered a serious condition?

Answer 2

It is sight-threatening and can lead to permanent blindness if untreated.

Question 3

Where does RD usually begin in the retina?

Answer 3

In the thinner peripheral retina.

Question 4

What causes most retinal detachments?

Answer 4

A hole or tear allowing sub-retinal fluid to leak through.

Question 5

What symptoms might a patient with RD experience?

Answer 5

Floaters, flashes of light, shadow in peripheral vision.

Question 6

What is photopsia?

Answer 6

Flashes of light seen in one or both eyes, common in RD.

Question 7

What is the annual prevalence of RD?

Answer 7

Approximately 1 in 10,000 people.

Question 8

Which ethnic group has a higher risk of RD?

Answer 8

Asian

Question 9

What are the three main types of RD?

Answer 9

Rhegmatogenous, tractional, and exudative.

Question 10

What causes rhegmatogenous RD?

Answer 10

Retinal break/tear through which vitreous fluid enters sub-retinal space.

Question 11

What causes tractional RD?

Answer 11

Fibrovascular tissue pulls retina away from RPE, often due to inflammation or neovascularization.

Question 12

What is exudative RD associated with?

Answer 12

Fluid leakage from choroid through damaged RPE without retinal break—can result from inflammation, tumors, or vascular issues.

Question 13

What is ‘rhegma’

Answer 13

Greek for “break”—relevant in rhegmatogenous RD.

Question 14

How does high myopia contribute to RD?

Answer 14

It stretches and thins the retina, increasing RD risk.

Question 15

How much more likely is RD in patients with -3DS compared to non-myopes?

Answer 15

x 10 more likely

Question 16

What is the RD risk in aphakia or pseudophakia?

Answer 16

20–40% of rhegmatogenous RDs occur post-cataract extraction.

Question 17

What unusual activities are linked to RD risk?

Answer 17

Bungee jumping and pregnancy pre-eclampsia.

Question 18

How can trauma cause RD?

Answer 18

Through direct impact, dislocated lens, or vitreous hemorrhage.

Question 19

Name two systemic conditions associated with RD.

Answer 19

Marfan’s syndrome and sickle cell disease.

Question 20

What causes RD in infants?

Answer 20

Birth trauma or shaken baby syndrome.

Question 21

What imaging methods are used for RD diagnosis?

Answer 21

Fundus photography and Optical Coherence Tomography (OCT).

Question 22

What is the primary goal of RD surgery?

Answer 22

Seal the retinal holes and restore retinal contact with the choroid to preserve vision.

Question 23

What is pneumatic retinopexy?

Answer 23

A gas bubble is injected into the eye to press the retina against the RPE.

Question 24

What is a major limitation of pneumatic retinopexy?

Answer 24

Ineffective for lower retinal detachments due to gravity.

Question 25

What is cryotherapy's role in RD?

Answer 25

Freezes retina to choroid to create a scar that seals the break.

Question 26

How does laser photocoagulation work?

Answer 26

Applies burns around a retinal hole to seal it using heat.

Question 27

What is a pars plana vitrectomy?

Answer 27

Surgical removal of the vitreous humor and replacement with gas/silicone to reattach retina.

Question 28

What is scleral buckling?

Answer 28

Silicone band placed to indent the sclera and close retinal breaks.

Question 29

What’s the success rate of RD treatment after one procedure?

Answer 29

80–90%.

Question 30

Can patients require multiple RD treatments?

Answer 30

Yes, depending on individual response and condition severity.

Question 31

What is a common refractive change after scleral buckling?

Answer 31

Myopic shift.

Question 32

What are ocular motility issues post-surgery?

Answer 32

Torsion, fusion loss, and induced strabismus.

Question 33

Define aniseikonia.

Answer 33

Perception of unequal image sizes from each eye.

Question 34

What factors increase the risk of motility imbalance?

Answer 34

Number of surgeries, buckle size, macular involvement, and poor vision.

Question 35

What is the impact of improved visual acuity on ocular alignment?

Answer 35

It enhances fusion and reduces ocular motility restriction.

Question 36

What key assessments do orthoptists perform in RD cases?

Answer 36

VA, CT, OM, binocular function, stereoacuity, and imaging.

Question 37

What are orthoptic management strategies post-RD surgery?

Answer 37

Observation, prisms, occlusion therapy, and refraction.

Question 38

What type of prism is commonly used early on?

Answer 38

Fresnel prism

Question 39

When might strabismus surgery be considered post-RD?

Answer 39

When diplopia or ocular misalignment persists after healing.

Question 40

What is the challenge of strabismus surgery post-RD?

Answer 40

Scar tissue, risk of re-detachment, and explant extrusion.

Question 41

What is a retinal detachment? A. When the lens comes away from the sclera B. When the neurosensory retina comes away from the retinal pigment epithelium C. A sight threatening condition which can cause blindness if untreated D. When the retina falls out of the globe

Answer 41

B

Question 42

What are some of the signs and symptoms of retinal detachment?

Answer 42

Sudden floaters, photopsia (flashes), blurred or reduced vision, peripheral shadow, painless vision loss.

Question 43

What are the 3 main types of retinal detachment and which one is the most common?

Answer 43

Rhegmatogenous (most common), tractional, and exudative.

Question 44

What imaging techniques could be useful for the detection of a retinal detachment?

Answer 44

OCT and fundus photos