vr disorders retinal detachment (rd) ayesha s abdullah 06.02.2015

VR Disorders Retinal

Detachment (RD)

Ayesha S Abdullah06.02.2015

DEVELOPMENT OF THE EYE

What is RD?

Separation of the neurosensory retina from the retinal pigment epithelium

TYPES

Rhegmatogenous RD Non- rhegmatogenous RD

– Exudative RD– Tractional RD

Combined Tractional Rhegmatogenous

Epidemiology

1 in 10,000/ year Bilateral in about 10% Risk factors? An ophthalmic emergency

RRD

Vitreo-retinal adhesions disc, ora, blood vessels & at fovea

Potential subretinal space

Some Anatomical Considerations

RRD

RD secondary to a break in the retina

Causes & risk factors

PVD Lattice degeneration, 8% in general

population, 40% in eyes with RD Myopia Post- Cataract surgery (pseudophakia) Trauma

Clinical presentation –symptoms

Flashes of light Floaters Visual loss Visual field loss Usually an acute event History of predisposing factors, myopia,

cataract surgery, trauma etc

Field loss

Clinical examination –signs

Significantly reduced Visual acuity Anterior segment examinationPupils, (RAPD)Posterior segment examinationVitreous- tobacco dustRetinal signsIOP ( may be low)

Clinical examination –signs

Direct Ophthalmoscopy

Indirect Ophthalmoscopy

Normal fundus

Retinal detachment with tear

RD

RD with giant tear

Tractional RD

Principles of management

External temponade/ scleral buckling– Seal the break– Create a buckle– Drain the SRF (subretinal fluid)-if required

Internal temponade

Prophylaxis of RRD

Photocoagulation of the risky lesions with laser

So patients with risk factors should be referred to an ophthalmologist

Announcements

HW 5 risk factors for RDThree common causes of exudative

retinal detachment Last date for submission 20th Feb 2015msqheartline@hotmail.com Test in topics covered in 4th year

after VR finishes