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Retinal Detachment

From Mediwikis

This medical emergency is where the retina begins to peel away from the eye. Permanent damage to vision may occur within 24-72 hours of onset.

Slit lamp photograph showing retinal detachment in Von Hippel-Lindau disease

Causes

Presentation[1]

Sudden onset of symptoms, indicating a posterior vitreous detachment, which precedes a retinal detachment

  • Flashes of light in peripheral vision
  • "Floaters" around vision
  • Feeling of "heaviness" in eye

Later symptoms of detachment:

  • Dense shadow across vision- starting peripherally, and moving centrally
  • A "veil/curtain" across the field of vision
  • Straight lines appear curved
  • Central visual field loss

Investigation

  • Fundus photography, or ophthalmoscopy if not possible
  • Alternatively ultrasound shows "flying angel" sign

Management

All suspected retinal detachment should be urgently referred to opthalmology.

  • Cryopexy/ laser photocoagulation limits spread of detachment
  • Scelral buckle surgery
  • Pneumatic retinopexy
  • Vitrectomy

85% are successfully treated with one operation, with 15% requiring more operations. Visual acuity may reduce after the detachment. Overall the prognosis is around 95%.[2]

References

  1. http://www.rnib.org.uk/eye-health-eye-conditions-z-eye-conditions/retinal-detachment
  2. Yanoff, Myron; Duker, Jay S. (2008). Ophthalmology (3rd ed.). Edinburgh: Mosby. ISBN 978-0323057516.