1. VR Disorders Retinal Detachment (RD)
Ayesha S Abdullah

5. DEVELOPMENT OF THE EYE

6. What is RD?
Separation of the neurosensory retina from the retinal pigment epithelium

7. Non- rhegmatogenous RD
TYPES
Rhegmatogenous RD
Non- rhegmatogenous RD
Exudative RD
Tractional RD
Combined Tractional Rhegmatogenous

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

9. RRD Some Anatomical Considerations
Vitreo-retinal adhesions disc, ora, blood vessels & at fovea
Potential subretinal space

12. RRD
RD secondary to a break in the retina

14. Causes & risk factors PVD
Lattice degeneration, 8% in general population, 40% in eyes with RD
Myopia
Post- Cataract surgery (pseudophakia)
Trauma
PVD In 15% of cases with Posterior vitreous detachment (PVD) a tear develops in the retina
Lattice degeneration 60% of tears develop in peripheral retina with retinal degenerations like Lattice degeneration
Myopia 40% of the RD occur in myopic eyes; the higher the error the greater the risk
Post- Cataract surgery (pseudophakia) especially in eyes with retinal degeneration and myopia can develop retinal tears and RRD

15. 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

16. Field loss

17. Clinical examination –signs
Significantly reduced Visual acuity Anterior segment examination Pupils, (RAPD) Posterior segment examination Vitreous- tobacco dust Retinal signs IOP ( may be low)

18. Clinical examination –signs
Direct Ophthalmoscopy

19. Indirect Ophthalmoscopy

20. Normal fundus

21. Retinal detachment with tear

22. RD

23. RD with giant tear

24. Tractional RD

25. Principles of management
External temponade/ scleral buckling
Seal the break
Create a buckle
Drain the SRF (subretinal fluid)-if required
Internal temponade

31. Prophylaxis of RRD Photocoagulation of the risky lesions with laser
So patients with risk factors should be referred to an ophthalmologist

32. Announcements HW 5 risk factors for RD
Three common causes of exudative retinal detachment
Last date for submission 20th Feb 2015
Test in topics covered in 4th year after VR finishes