RETINAL DETACHMENT

LM 68/F/M
Mambusao, Capiz
CC: blurring of vision OD

HISTORY OF PRESENT ILLNESS

• 10 mos PTC, gradual loss of vision OD
• Pertinent negatives:
• Eye pain
• Pruritus
• Discharges

PAST MEDICAL HISTORY

• Unremarkable as claimed
• No consult done

FAMILY HISTORY

• Unremarkable

PERSONAL AND SOCIAL HISTORY

• Non alcoholic beverage drinker
• Non smoker

EYE EXAMINATION

VISUAL ACUITY

• OD: HM -> HM
• OS: CF 4ft -> 20/200-2

INSPECTION and PALPATION

• No gross discoloration
• Fleshy lesion noted OS ~ 2mm
• No masses palpated

EXTRA-OCULAR MUSCLES

INTRA-OCULAR PRESSURE

FUNDUSCOPY (DIRECT)

• OD: retinal detachment, inferior
• OS: retinal nerve fiber layer thinning

SLIT LAMP EXAMINATION

VISUAL FIELDS EXAMINATION

• OD: px cannot visualize
• OS: same with examiner

ASSESSMENT

• Retinal Detachment OD
• Diabetic Nephropathy OS

MANAGEMENT

CASE DISCUSSION

RETINAL DETACHMENT

• Separation of sensory retina from RPE
• 3 types:
• Rhegmatogenous
• Traction
• Serous or hemorrhagic

RHEGMATOGENOUS

• Break in the neuronal layer
• Fluid from vitreous cavity seep in between
• Treat retinal breaks

TRACTION

• Inflammatory or vascular fibrous membranes
• Tether to the vitreous
• Proliferative diabetic retinopathy

SEROUS AND HEMORRHAGIC

• Accumulation of fluid beneath sensory retina
• Subretinal neovascularization

PUPILS

• Pupillary light reflex normal OU
• Anisocoria:
• 4 mm OD, non-reactive
• 2 mm OS, Brisk