Retinal Detachment

• Retinal Detachment 


  Separation of the two primitive layers of the retina (melanin epithelial pigment and the rods and cones layer) or it may be separation of the entire retina from the choroid due to the presence of a tumor
• Retinal Detachment Clinical Manifestations

  Pathognomonic Sign: Curtain-like vision
• Retinal Detachment Clinical Manifestations

  • Floaters or black spots - blood and retinal cells casting shadows on the retina
  • Flashes of light - light entering the eye is not absorbed by the detached melanin epithelial pigment
  • Progressive constriction of vision in one area
  • Ophthalmoscopy: Cloudy vitreous 
  • Portion of retina appears like a hanging gray cloud in opthalmoscopy
  • (-) PAIN
• Retinal Detachment Management

  • Promote bedrest and cover the eyes - to prevent further detachment.
  • Position the head so that the retinal hole is in the lowest part of the eye (dependent position)
  • Early surgery is required (e.g. scleral buckling)
• Retinal Detachment Surgery

  Scleral Buckling - To hold the choroid and retina together with a splint until scar tissue forms closing the tear
• Retinal Detachment Surgery

  Cryosurgery - Cold probe applied to sclera - stimulate infammatory resposne - adhesion
• Retinal Detachment Surgery

  Diathermy - heat through the sclera - infammatory response - adhesion
• Retinal Detachment Postop

  • Hemorrhage: floaters 
  • IOP: severe eye pain
  • Position: Affected area should be superior or as prescribed by surgeon
  • Sunglasses when going outside 
  • Eye patch during day 
  • Metal Shield during night
  • Sedentary activities resumed after 3 weeks
  • Activities requiring heavy physical exertion permitted after 6 weeks