The patient is presenting with episodes of flashers and floaters and a fundoscopic exam positive for retinal “crinkling,” suggesting the diagnosis of retinal detachment. Retinal detachment will also be associated with “curtain drawn down” vision loss.
Retinal detachment refers to the separation of the layers of the retina. These patients complain of photopsia (flashes of light) and showers of floaters (spots in the visual field), which are both associated with posterior vitreous detachment. This may then progress to the most classic description of retinal detachment, which is “curtain coming down” vision loss. Fundoscopic examination will reveal a crinkling and/or grey retina and changes in vessel direction. This is a surgical emergency, treated by either laser therapy or cryotherapy to create permanent adhesions.
Figure A shows a crinkling and grey retinal area, characteristic of retinal detachment. Illustration A is a fundoscopy showing soft, yellow drusen in the macula region.
Answer 1: Halos around lights may be seen with acute narrow-angle glaucoma. Other symptoms include pain, vision loss, rock-hard eye, red eye, and frontal headache. Fundoscopic exam shows characteristic optic disc cupping.
Answer 3: Metamorphopsia is vision distortion, which can be seen with age-related macular degeneration (ARMD). Dry ARMD on fundoscopic exam appears as yellow retinal drusen deposits (Illustration A). Wet ARMD on fundoscopic exam will show neovascularization.
Answer 4: Scotoma is central vision loss, characteristic of age-related macular degeneration.
Answer 5: Conjunctival injection can be seen with many ophthalmic pathologies, such as conjunctivitis caused by allergies, bacterial infections, or viral infections.
Retinal detachment presents with “flashers” and “floaters,” and may progress to a “curtain coming down” vision loss.