Retinal Detachment RD, st. John Eye Hospital, Moh. Al-Khaldi, 2014

RETINAL DETACHMENT

Mohammed Al-KhaldiMPH

04/13/23 Retinal Detachment, Mohammed Al-Khali, 2014, St John Eye Hospital. 1

RD related Epidemiological facts

• The incidence of RD in otherwise normal eyes is around 5 new cases in 100,000 persons per year.

• RD is more frequent in middle-aged or elderly, with rates of around 20 in 100,000 per year, and the lifetime risk in normal individuals is about 1 in 300.

• RD is more common in people with severe myopia (above 5–6 diopters), in whom the retina is more thinly stretched. In such patients, lifetime risk rises to 1 in 20.

• About two-thirds of cases of RD occur in myopics. Myopic retinal detachment patients tend to be younger than non-myopic ones.


Contd,

RD related Epidemiological facts• RD is more frequent after surgery for cataracts. The estimated

long-term prevalence of RD after cataract surgery is in the range of 5 to 16 per 1000 cataract operations, but is much higher in patients who are highly myopic, with a prevalence of up to 7% being reported in one study.

• A study found that the probability of experiencing retinal detachment within 10 years of cataract surgery may be about 5 times higher than in the absence of treatment.

• Although RD usually occurs in just one eye, there is a 15% chance of it developing in the other eye, and this risk increases to 25–30% in patients who have had a retinal detachment and cataracts extracted from both eyes.


RETINA• light-sensitive layer

of tissue • sends visual

messages through the optic nerve


• pulled away from the underlying choroid

• small areas of the retina torn =>

retinal tears or retinal breaks

• retinal cells deprived of oxygen

• if not promptly treated => permanent vision loss



SYMPTOMS• floaters - bits of debris in field of vision that

look like spots, hairs or strings



SYMPTOMS• floaters• light flashes• shadow or curtain over a

portion of visual field • blur in vision


Can occur as a result of:

• trauma • advanced diabetes • an inflammatory disorder, such as

sarcoidosis• shrinkage of the jelly-like vitreous that fills

the inside of the eye


• vitreous liquid leaks through retinal tear and accumulates underneath retina

• retina can peel away from underlying layer of blood vessels


Factors that may increase risk of retinal detachment

• aging - more common in people older than 40 • previous retinal detachment in one eye • family history of retinal detachment • extreme nearsightedness • previous eye surgery• previous severe eye injury or trauma


TREATMENTSRetinal tears:• laser surgery (photocoagulation)• freezing (cryopexy)Retinal detachment:• pneumatic retinopexy• scleral buckling• vitrectomy


PHOTOCOAGULATION


CRYOPEXY


PNEUMATIC RETINOPEXY


PNEUMATIC RETINOPEXY


SCLERAL BUCKLING


VITRECTOMY


When a surgeon injects a bubble of expandable gas into the vitreous cavity it is called:

• scleral buckling• vitrectomy• pneumatic retinopexy• photocoagulation• cryopexy


Important hint related to the results of surgery

85 % of the cases dealt with successfully in a single operation with 15 % of the remaining cases need to be two or more. After treatment, patients regain their vision therapists gradually over a period of a few weeks, despite the fact that visual acuity may not be as good as it was before the detachment, especially if the spot included in the detachment.


Retinal detachment can occur as a result of;•Obesity•Trauma•Nearsightedness


When a surgeon uses intense cold to freeze the retina around the retinal tear it is called;

• Scleral buckling• Vitrectomy• Pneumatic retinopexy• Photocoagulation• Cryopexy



Health & Medicine

Retinal Detachment RD, st. John Eye Hospital, Moh. Al-Khaldi, 2014