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Know the Common Retinal Disorders Including Detachment, Retinal Vascular Disorders and the Use of Lasers.Edit

DetachmentEdit

Aetiology

Separation of the neuroretina from the underlying retinal pigment epithelium. An accumulation of subretinal fluid occurs and increases the separation. 

Epidemiology

  • Rhegmatogenous: - meaning that a tear has occurred as a result of traction. Most common.
  • Tractional secondary to fibrotic eye disease
  • Exudative 
  • Traumatic
  • Post-operative


Myopic eyes are more likely to suffer a retinal detachment; the higher the myopia, the greater the risk. 

Signs and Symptoms

Classically remembered as the 4 Fs"

  • Floaters - many, acute onset, constant and described as "spider's web"
  • Flashes 
  • Field loss - acute and progressive
  • Falling acuity - sometimes described as "a curtain coming down over the vision"


Fundoscopy 

Detachedretina

From medweb4.bham.ac.uk. retinal detachment "ballooning" from 6-9 o' clock
















Managment


Surgery:

- Scleral buckling to form an external tamponade

- Vitrectomy & gas/silicone oil injection to form an internal tamponade

- Cryotherapy or laser coagulation is used to secure the retina


The video below demonstrates all three techniques

Scleral Buckle and Vitrectomy for Retinal Detachment

Scleral Buckle and Vitrectomy for Retinal Detachment

full







Prognosis

Generally good if surgery is performed before macula detaches.

Post operative re-detachment occurs in 5 - 10 % of cases


Retinal Vascular DisordersEdit

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