Retinal Detachment

Question 1

Definition

Answer 1

• Where the retina separates from the choroid underneath.
• Usually due to a retinal tear that allows vitreous fluid to get under the retina and fill the space between the retina and the choroid.
• Outer retina relies on the blood vessels of the choroid for it’s blood supply.
• Sight threatening emergency unless recognised and treated quickly.

Question 2

Risk factors

Answer 2

• Posterior vitreous detachment
• Diabetic retinopathy
• Trauma to the eye
• Retinal malignancy
• Older age
• FHx

Question 3

Presentation

Answer 3

• Periphera vision loss (often sudden and like a shadow coming across the vision).
• Blurred and distorted vision.
• Flashes and floaters.

Question 4

Management

Answer 4

• Should be assessed by someone with appropriate skillset to detect retinal tears or detachment - referral to ophthalmology
• Retinal tears:
  
  • Laser therapy
  • Cryotherapy
• Retinal detachment:
  
  • Vitrectomy (removing parts of the vitreous body and replacing with oil or gas)
  • Scleral buckling (silicone ‘buckle’ to put pressure on the outside of the eye so that the outer eye indents to bring the choroid inwards and into contact with the detached retina)
  • Pneumatic retinopexy (has bubble injected into the vitreous body and positioning the patient so the bubble creates pressure that flattens the retina against the choroid and close the detachment)