Know the Common Retinal Disorders Including Detachment, Retinal Vascular Disorders and the Use of Lasers.[]
Detachment[]
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
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
Prognosis
Generally good if surgery is performed before macula detaches.
Post operative re-detachment occurs in 5 - 10 % of cases