Retinal detachment is a serious eye condition where the retina pulls away from its normal position, risking permanent vision loss if untreated. Key warning signs include reduced vision, floaters, and flashes of light, and various causes include rhegmatogenous detachments, tractional detachments, and exudative detachments. Treatment options often involve surgical procedures such as laser surgery, vitrectomy, or scleral buckling, along with specific nursing responsibilities to prepare and care for the patient pre- and post-operatively.

1. MS. PRASANNA.K
NURSING TUTOR
GANGA COLLEGE OF NURSING
COIMBATORE

3. • Retinal detachment describes an emergency
situation in which a thin layer of tissue (the retina) at
the back of the eye pulls away from its normal
position.
• Retinal detachment separates the retinal cells from
the layer of blood vessels that provides oxygen and
nourishment to the eye. The longer retinal
detachment goes untreated, the greater your risk of
permanent vision loss in the affected eye.

5. Warning signs of retinal detachment may include one or all
of the following:
• reduced vision
• sudden appearance of floaters and flashes of light.
• Contacting an eye specialist (ophthalmologist) right
away can help save your vision. Blurred vision
• Gradually reduced side (peripheral) vision
• A curtain-like shadow over your field of vision

6. CAUSES
• Rhegmatogenous (reg-ma-TODGE-uh-nus). Rhegmatogenous
detachments are caused by a hole or tear in the retina that allows fluid
to pass through and collect underneath the retina. This fluid builds up
and causes the retina to pull away from underlying tissues. The areas
where the retina detaches lose their blood supply and stop working,
causing you to lose vision.
• Tractional [scar tissue growth] detachment is typically seen in people
who have poorly controlled diabetes or other conditions.
• Exudative In this type of detachment, fluid accumulates beneath the
retina, but there are no holes or tears in the retina. Exudative
detachment can be caused by age-related macular degeneration, injury
to the eye, tumors or inflammatory disorders.

7. • Aging — retinal detachment is more common in people over
age 50
• Previous retinal detachment in one eye
• Family history of retinal detachment
• Extreme nearsightedness (myopia)
• Previous eye surgery, such as cataract removal
• Previous severe eye injury
• Previous other eye disease or disorder, including
retinoschisis, uveitis or thinning of the peripheral retina
(lattice degeneration)

8. • Retinal examination
• Ultrasound imaging

9. • Laser surgery (photocoagulation). The surgeon
directs a laser beam into the eye through the pupil.
The laser makes burns around the retinal tear,
creating scarring that usually "welds" the retina to
underlying tissue.
• Freezing (cryopexy). After giving you a local
anesthetic to numb your eye, the surgeon applies a
freezing probe to the outer surface of the eye
directly over the tear. The freezing causes a scar
that helps secure the retina to the eye wall.

10. Draining and replacing the fluid in the eye. In
this procedure, called vitrectomy
Injecting air or gas into your eye. In this
procedure, called pneumatic retinopexy
Indenting the surface of your eye. scleral
buckling, involves the surgeon sewing (suturing) a
piece of silicone material to the white of your eye
(sclera) over the affected area

11. NURSES RESSPONSIBILITIES
1. Prepare the patient for surgery.
1. Instruct the patient to remain quiet in prescribed (dependent) position, to keep the detached
area of the retina in dependent position.
2. Patch both eyes.
3. Wash the patient’s face with antibacterial solution.
4. Instruct the patient not to touch the eyes to avoid contamination.
5. Administer preoperative medications as ordered.
2. Take measures to prevent postoperative complications.
1. Caution the patient to avoid bumping head.
2. Encourage the patient no to cough or sneeze or to perform other strain-inducing activities that
will increase intraocular pressure.
3. Encourage ambulation and independence as tolerated.
4. Administer medication for pain, nausea, and vomiting as directed.

12. NURSES RESPONSIBILITIES
 Provide quiet diversional activities, such as listening to a radio or audio books.
 Teach proper technique in giving eye medications.
 Advise patient to avoid rapid eye movements for several weeks as well as straining
or bending the head below the waist.
 Advise patient that driving is restricted until cleared by ophthalmologist.
 Teach the patient to recognize and immediately report symptoms that indicate
recurring detachment, such as floating spots, flashing lights, and progressive
shadows.
 Advise patient to follow up.

13. • Discharge and Home Healthcare Guidelines
• Have the patient or significant others demonstrate the correct
technique for instilling eye drops. Instruct the patient to wash her
or his hands before and after removing the dressing; using a clean
washcloth, cleanse the lid and lashes with warm tap water; tilt the
head backward and inclined slightly to the side, so the solution
runs away from the tear duct and other eye to prevent
contamination; depress the lower lid with the finger of one hand.
Tell the patient to look up when the solution is dropped on the
averted lower lid; do not the place drop directly on the cornea.
• Do not touch any part of the eye with the dropper; close the eye
after instillation, and wipe off the excess fluid from the lids and
cheeks. Close the eye gently so the solution stays in the eye
longer.

14. Teach the patient to use warm or cold compresses for
comfort several times a day. Note that the patient should
wear either an eye shield or glasses during the day, during
naps, and at night.
Teach the patient to avoid vigorous activities and heavy lifting
for the immediate postoperative period.
Teach the patient the symptoms of retinal detachment and
the action to take if it occurs again.
Instruct the patient about the importance of follow-up
appointments, which may be every few days for the first
several weeks after surgery.