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Key Features

  • Retinal detachment is most commonly secondary to development of a tear in the retina, which is usually spontaneous but may be secondary to trauma

  • Spontaneous detachment is most common in patients age > 50

  • Cataract extraction and myopia are the two most common predisposing causes

Clinical Findings

  • Blurred vision in the involved eye, becoming progressively worse

  • Often described as a curtain descending over the field of vision

  • Central vision remains intact until the macula becomes detached

  • No pain or redness

Diagnosis

  • On ophthalmoscopic examination, the retina may be seen hanging like a gray cloud

Treatment

  • Urgent referral to ophthalmologist is critical

  • During transportation, patient's head should be positioned so that the detached portion of the retina will fall back with the aid of gravity

  • Surgical therapy involves closing the retinal defects by creating a permanent adhesion between the neurosensory retina, retinal pigment epithelium, and choroid

  • Indentation of the sclera with a silicone sponge or buckle, drainage of subretinal fluid, surgical removal of the vitreous (vitrectomy), or injection of an expansile gas into the vitreous cavity may be required

  • Expansile gas within the eye, which may persist for weeks, is a contraindication to air travel, mountaineering at high altitude, and nitrous oxide anesthesia

  • About 90% of uncomplicated cases are cured with one operation

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