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Retinal Detachment

Topic updated on 06/02/17 8:12am

Snap Shot
  •  retinal detachmentA 65-year-old man presents with sudden vision loss in which he describes the event as "a curtain lowered over my eye." This was preceded by seeing "floaters."
  • Pathophysiology
    • separation of neurosensory layer of retina from pigment epithelium
    • without the support of pigment epithelium the photoreceptors degenerate
  • Risk factors
    • trauma
    • diabetes
    • severe myopia
    • cataract surgery
  • Symptoms
    • painless, sudden vision loss 
    • photopsia (sudden flashes or light)
    • "floaters" in the visual field
      • extent of retinal detachment can be assessed by the number of floaters present
  • Physical exam
    • gray, elevated retina
  • Surgical
    • laser reattachment of the retina
Prognosis, Prevention, and Complications
  •  Permanent vision loss if not rapidly repaired


Qbank (1 Questions)

(M2.OP.4754) A 69-year-old man arrives to your clinic complaining of progressively worsening episodes of seeing flashes of light, and small objects floating in his visual fields. He reports that he has “severe near-sightedness,” but had not noticed any significant change in his vision clarity. Then, within the past month, the patient noticed flashes of light within the vision of his right eye, which were accompanied by “showers of floaters.” He reports that these episodes have become more frequent. The patient's medications include metformin, for his type II diabetes mellitus, atorvastatin, for his high cholesterol, and daily aspirin. The patient’s temperature is 98.2°F (37.8°C), blood pressure is 130/78 mmHg, pulse is 72/min, and respirations are 14/min with an oxygen saturation of 99% O2 on room air. Physical exam is unremarkable. Fundoscopic exam of the right eye is shown in Figure A. Which of the following would this patient also likely experience? Topic Review Topic
FIGURES: A          

1. Halos around lights
2. “Curtain drawn down” vision loss
3. Metamorphopsia
4. Scotoma
5. Conjunctival injection


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