2. • The retina is the light sensitive tissue lining the back of our eye which
coverts the light rays into impulses that travels through the optic
nerve to the brain.
• Retina consist of two parts separated by the subretinal space.
NEUROSENSORY RETINA
• A thin transparent layer of connecting neural cells transmitting
impulses to optic nerve.
RETINAL PIGMENTED EPITHELIUM(RPE)
• A single layer of pigmented cells which maintain photoreceptor
physiology by synthesizing and storing metabolites and vitamins.
INTRO
3. RETINAL DETACHMENT
• It is the separation of neurosensory
retina from the pigment epithelium.
• Normally these two layers are loosely
attached to each other with a
potential space in between
• Without treatment permanent loss of
vision may occur.
4.
5. RISK FACTORS
• Retinal tears
• Trauma
• Family history
• Complication after cataract surgery
• Injury
• Advanced diabetes
• High impact sports or high speed sports
6. cont..
•Aging – more common in people over age 50
years.
•Previous retinal detachment in one eye
•A family history of retinal detachment
•Previous other eye disease or inflammation
• Severe myopia.
7. TYPES
Can be classified into three types:
1. Rhegmatogenous (primary retinal detachment).
2. Tractional retinal detachment (Secondary retinal
detachment)
3. Exudative retinal detachment
8. RHEGMATOGENOUS RETINAL DETACHMENT
• RRD occurs due to break in the retina (called retinal tear)that
allows fluid to pass from the vitreous space into the sub
retinal space between the sensory retina and the retinal
pigment epithelium
• It is the most common.
• Retinal break are divided into three types:
holes
tears
dialyses
9. cont.
• Holes form due to retinal atrophy of the sensory
retina and may be round or oval especially within an
area of lattice degeneration
• Tears are due to vitreoretinal traction
• Dialyses are peripheral and circumferential tears along
the oraserrata with vitreous gel attached to the
posterior margins.
10.
11.
12. EXUDATIVE OR SECONDARY RETINAL DETACHEMENT
• Occurs due inflammation ,injury or vascular abnormalities
that results in fluid accumulating underneath the retina
without the presence of a hole ,tear or break.
• CAUSES
• Intraocular tumors
• Posterior uveitis
• Central serous retinopathy
13.
14. TRACTIONAL RETINALDETACHMENT
• Caused by traction (due to vitreal ,epiretinal or subretinal
membrane) pulling the neurosensory retina away from the
underlying RPE.
• Found in conditions such as
a. diabetic retinopathy
b. sickle cell disease
c. retinopathy of maturity
d. ocular trauma
15.
16. SIGNS AND SYMPTOMS
• Flashes of light –caused by traction on the retina and usually
seen in the periphery.
• Floaters hazy spots in the line of vision which moves with the
eye position due to drops of blood in the vitreous i.e. blood
vessels tears as the retina tears and by condensations in the
vitreous humor causing shadows to be cast on the retina.
• Peripheral field loss darkness in one field of vision when they
retina detaches in that area.
• Loss of central a vision visual acquity dramatically drops if
the macula becomes detached.
18. Retinal detachment can be examined by
• Ultrasound
• Fluorescein angiography
• Tonometry
• Ophthalmoscopy
• Color vision test
• Slit lamp examination
19. TREATMENT
• 1.Exudative retinal detachment due to transudate, exudate
and haemorrhage may undergo spontaneous regression
following absorption of the fluid.
• 2 Presence of intraocular tumours usually requires
enucleation.
20. SUBRETINAL FLUID DRAINAGE
• It allows immediate apposition between sensory retina and
RPE.
1.SRF drainage is done very carefully by inserting a fine needle
through the sclera and choroid into the sub retinal space and
allowing SRF to drain away.
2.To maintain chorio-retinal apposition for at least a couple of
weeks.
Scleral buckling i.e., inward indentation of sclera to provide
external tamponade is still widely used to achieve the above
mentioned goal successfully in simple cases of primary RD.
21.
22. Tractional retinal detachment
• It is difficult and requires pars plana vitrectomy to cut the
vitreoretinal tractional bands and internal tamponade .
• Prognosis in such cases is usually not so good.
