Retinal detachment
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")
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
- Linear probe (7.5-10-MHz) is preferred
- Have pt lightly close their eye; avoid excessive pressure on globe
Treatment
- Urgent ophtho referral within 24hr
See Also
Acute Onset Flashers and Floaters
Source
Tintinalli