Retinal detachment: Difference between revisions
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==Diagnosis== | ==Diagnosis== | ||
[[File:RetinalDetachment.jpeg|thumbnail]] | |||
#Examination | #Examination | ||
##Visual acuity and visual fields | ##Visual acuity and visual fields | ||
##Fundoscopic exam with dilation | ##Fundoscopic exam with dilation | ||
# [[Ultrasound: Ocular|Ultrasound]] | # [[Ultrasound: Ocular|Ultrasound]] | ||
==Treatment== | ==Treatment== |
Revision as of 06:24, 30 October 2014
Background
- Average age of onset ~55
- Types
- Rhegmatogenous (rhegma means "tear")
- As vitreous separates from retina the traction creates a hole in retina
- Fluid goes through the hole and peels the retina off like wallpaper
- As vitreous separates from retina the traction creates a hole in retina
- Exudative
- Fluid accumulates beneath the retina without a retinal tear
- Associated w/ neoplasm, inflammatory conditions, hypertension, preeclampsia
- Tractional
- Acquired fibrocellular bands in the vitrous contract and detach the retina
- Associated w/ DM, sickle cell, trauma
- Rhegmatogenous (rhegma means "tear")
- Distinguish between mac-off and mac-on
Clinical Features
- Abrupt onset of new "floaters" or flashes of light
- Vitreous tugs on the retina before separation
- Visual acuity loss (filmy, cloudy, or curtain-like) or visual field loss
- May be mild or dramatic
DDx
Diagnosis
- Examination
- Visual acuity and visual fields
- Fundoscopic exam with dilation
- Ultrasound
Treatment
- Urgent ophtho referral within 24hr
- In macular off retinal detachment, visual acute is significantly decreased if reattachment does not occur within 6 days. [1]
See Also
Acute Onset Flashers and Floaters
Source
Tintinalli
- ↑ Diederen R et al: Scleral buckling surgery after macula-off retinal detachment: Worse visual outcome after more than 6 days. Ophthalmology 2007; 114:705-709