Opthamology - Retinal Detachment

Front 1

Retinal Detachment: Definition

Back 1

A separation of the neurosensory retina from the retinal pigment epithelium

Front 2

Retinal Detachment: Classification by Cause

Back 2

Rhegmatogenous (common, caused by retinal tear)
Tractional (diabetes)
Exudative (rare)

Front 3

Retinal Detachment: Classification by Anatomy

Back 3

Macula-on: central vision spared, macula attached
Macula-off: central vision poor, macula detached

Front 4

Rhegmatogenous Retinal Detachment: Risk Factors

Back 4

Myopia, Family History, Previous Cataract Surgery, Trauma

Front 5

Retinal Detachment: Pathogenesis

Back 5

1) Increasing age = liquification of vitreous
2) Collapse of viteral matrix and formation of liquified pockets
3) Liquid moves suddenly behind the remaining solid matrix causing traction on vitreous
4) Posterior Vitreous Detachment causing traction on retina
5) Tear in neurosensory retina
6) Flow of liquid vitreous into subretinal space
7) Separation of sensory retina from RPE
8) Hypoxia and death of sensory retina (vision loss) without prompt treatment

Front 6

Retinal Detachment: Symptoms

Back 6

Photopsia (flashing lights), floaters, visual field defect, central vision loss (variable)

Front 7

Treatment of Retinal Tear

Back 7

Cryopexy

Front 8

Retinal Detachment: Treatment

Back 8

Pneumatic Retinopexy (gas bubble injection)
Scleral Buckling
Pars plana vitrectomy

Front 9

Pneumatic Retinopexy

Back 9

Reattach retina and close tear using gas bubble - seal with cryoxy
limitations - must keep head in same position for 10-12 days, lower success rate than surgery

Front 10

Scleral Buckling: Complications

Back 10

post-up pain, induced myopia, ptosis, diplopia, induced astigmatism, late erosion/extrusion

Front 11

Pars Plana Vetrectomy

Back 11

Remove vitreous, replace with long-acting gas tamponade
Must stay in one position post-op