Retinal Detachment

Retinal detachment is where the retina separates from the vascularised choroid layer, usually due to a tear, therefore allowing the vitreous fluid to escape behind and fill the space between the layers.

Risk factors:

• Trauma

• Posterior vitreous detachment

• Diabetic retinopathy

• Older age

• FHx

N.B. A viterious detachment won't present with visual loss, but retinal detachment will.

Presentation

• Sudden painless and progressive vision loss - Usually starts peripherally and progresses towards the centre as the tears extends i.e. like a curtain

• Floaters

• Flashes

• Blurred vision

Management

Managing the retinal tear - Laser therapy or Cryotherapy, which creates adhesions between the retina and choroid

Managing the retinal detachment:

• Vitrectomy – Vitreous attached to the retinal tear is removed, and a gas or oil bubble is added to span and close the tear until a scar forms

• Scleral buckling - Silicone ‘buckle’ is placed on the scleral surface. This indents the outer eye to make contact with the detached retina.

• Pneumatic retinopexy – Small, expansile gas bubble is injected into the vitreous in the right area to flatten the detached retina against the choroid