Retinal detachment

Question 1

What is retinal detachment?

Answer 1

Retinal detachment occurs when the neurosensory tissue that lines the back of the eye comes away from its underlying pigment epithelium.

Question 2

Is retinal detachment reversible?

Answer 2

Yes, it is a reversible cause of visual loss, provided it is recognised and treated before the macula is affected.

Question 3

What happens if retinal detachment is left untreated?

Answer 3

It will inevitably lead to permanent visual loss.

Question 4

List some risk factors for retinal detachment.

Answer 4

• Diabetes mellitus
• Myopia
• Age
• Previous surgery for cataracts
• Eye trauma (e.g., boxing)

Question 5

How does diabetes mellitus contribute to retinal detachment?

Answer 5

It occurs as a result of breaks in the retina due to traction by the vitreous humour.

Question 6

What are the common features of retinal detachment?

Answer 6

• New onset floaters or flashes
• Sudden onset, painless visual field loss
• Curtain or shadow progressing to the centre of the visual field

Question 7

What does the presence of floaters or flashes indicate?

Answer 7

They indicate pigment cells entering the vitreous space or traction on the retina.

Question 8

What happens if the macula is involved in retinal detachment?

Answer 8

Central visual acuity and visual outcomes become much worse.

Question 9

What may be the result of a detached macula on visual acuity?

Answer 9

Central acuity may be reduced to hand movements.

Question 10

What test may highlight a relative afferent pupillary defect?

Answer 10

The swinging light test.

Question 11

What are some findings during fundoscopy in retinal detachment?

Answer 11

• The red reflex is lost
• Retinal folds may appear as pale, opaque, or wrinkled forms

Question 12

What should be done if a patient has new onset flashes and floaters?

Answer 12

They should be referred urgently (<24 hours) to an ophthalmologist.

Question 13

What assessments should an ophthalmologist conduct for suspected retinal detachment?

Answer 13

• Slit lamp examination
• Indirect ophthalmoscopy for pigment cells and vitreous haemorrhage