Retinal detachment

Question 1

What is retinal detachment?

Answer 1

When the retina comes away from the retinal pigment epithelium and fluid accumulates in this potential space

Question 2

What are the three main types of retinal detachment?

Answer 2

Rhegmatogenous
Tractional
Exudative

Question 3

What causes rhegmatogenous detachment?

Answer 3

Old age - retinal tear

Question 4

What causes tractional detachment?

Answer 4

Proliferation and scaring in diabetes, retinal vein occlusion, proliferative sickle cell retinopathy, retinopathy of prematurity and blunt trauma

Question 5

What causes exudative detachment?

Answer 5

inflammation such as sarcoidosis and uveitis, choroidal tumours such as melanoma and metastases, choroidal neovascularisation, hypertensive choroidopathy, vitrectomy/laser therapy

Question 6

Name some symptoms an patient with retinal detachment may present with

Answer 6

Painless loss of vision - sudden/gradual
Flashing lights
Floaters
Curtain coming up over their vision

Question 7

What may be seen on clinical examination in someone with retinal detachment?

Answer 7

Reduced VA - mac off
Opaque translucent layer
PVD
Vitreous haemorrhage
Retinal tears/tobacco dust

Question 8

List some investigations for retinal detachment

Answer 8

Slit lamp
Indirect ophthalmoscopy - locate the tear’
B scan - USS of eye

Question 9

Describe the management of retinal detachment

Answer 9

Urgent vitrectomy - gas/silicone oil endotamponade

Scleral buckle