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Retinal DetachmentAka: Detached Retina
- Epidemiology
- Incidence (U.S.): one in 10,000 per year
- Lifetime risk: 1 in 300 patients
- Pathophysiology
- Retina detaches from underlying epithelium
- Types and associated causes
- Exudative or serous retinal detachment
- Sarcoid Uveitis
- Severe Hypertension
- Neoplasm
- Tractional retinal detachment
- Fibrosis due to trauma or retinopathy
- Rhegmatogenous retinal detachment (most common)
- Posterior Vitreous Detachment (confers 10-15% risk)
- Common age >60 years
- Risk Factors
- Most common risks
- Myopia (Near-sightedness, due to egg-shaped globe)
- Eye Trauma
- Coagulopathy
- Older age (especially age > 60 years)
- Prior Cataract surgery (decreases vitreous): 1% risk
- Other risk factors
- Diabetic Retinopathy
- Retinopathy of Prematurity
- Congenital Cataracts
- Congenital Glaucoma
- Retinal detachment Family History
- Symptoms
- Acute, painless vision loss
- Develops peripherally and progresses centrally
- Develops over a course of hours or longer
- Shadow or curtain sensation falls over affected eye
- Unilateral Photopsia (Light Flashes seen)
- Metamorphopsia (wavy distortion of vision)
- Unilateral increase in n umber of Floaters
- Signs
- Ophthalmoscope may not show lesion
- Differential Diagnosis
- See Floaters (Entopsias)
- See Flashing Lights (Photopsias)
- See Acute Vision loss
- Imaging
- Ophthalmic ultrasonography
- Indicated if Ophthalmoscopy is non-diagnostic
- Management
- Immediate ophthalmology referral
- Procedures
- Scleral buckling
- Posterior vitrectomy
- Pneumatic retinopexy
- Prognosis (with surgical repair)
- Good prognosis unless central macula involvement
- Complications
- Proliferative vitreoretinopathy
- Fibrosis forms within weeks of repair
- Prevention
- Sports Eye Protection
- Posterior Vitreous Detachment
- May require laser "tacking" of retina
- Aggressively follow patients with new onset
- Higher risk if increase in Floaters present
- References
- Banker (2001) Ophthalmol Clin North Am 14(4):695
- Gariano (2004) Am Fam Physician 69:1691
Retinal Detachment (C0035305)
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| Definition (MSH) | Separation of the inner layers of the retina (neural retina) from the pigment epithelium. Retinal detachment occurs more commonly in men than in women, in eyes with degenerative myopia, in aging and in aphakia. It may occur after an uncomplicated cataract extraction, but it is seen more often if vitreous humor has been lost during surgery. (Dorland, 27th ed; Newell, Ophthalmology: Principles and Concepts, 7th ed, p310-12). |
| Definition (CSP) | separation of the inner layers of the retina from the pigment epithelium. |
| Concepts | Disease or Syndrome (T047)
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| ICD9 | 361.9 |
| Basque | ERRETINAREN DESPRENDIMENTUA |
| Danish | Nethindelosning |
| Dutch | Netvlies loslating |
| English | Detached retina, DETACHMENT RETINAL, retina detachment, RETINAL DETACHMENT, Retinal Detachments, Sensory retinal detachment, Unspecified retinal detachment |
| Finnish | VERKKOKALVON IRTOAMINEN |
| French | Decollement de la retine |
| German | Netzhautabloesung |
| Hebrew | hafradat rishtit |
| Hungarian | retinalevalas |
| Italian | Distacco di retina |
| Norwegian | NETTHINNEAVLOSNING |
| Portuguese | Descolamento da retina |
| Spanish | Desprendimiento de retina, desprendimiento retiniano |
| Swedish | NATHINNEAVLOSNING |
| Credits | Derived from the NIH UMLS (Unified Medical Language System)
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