RD FOR UG

1. RETINAL
DETATCHMENT
BY DR NITISH

2. RETINAL DETATCHMENT
Separation of neurosensory retina from retinal pigment
epithelium
Caused by breakdown the forces that attatch the NSR
to the RPE

3. TYPES
Rhegmatoenous RD
Tractional RD
Exudative RD

4. RHEGMATOGENOUS RD
Occurs due to full thickness defect in neurosensory
retina which permit fluid from synchytic vitreous to
enter into subretinal space

5. RISK FACTORS
Age - MC in 40-60 yrs age
Sex - MC in males M:F -3:2
Myopia
Aphakia
Retinal degenerations – lattice degen , snail tract degen ,
retinoschisis
Trauma
Senile PVD

6. CLINICAL FEATURES
SYMPTOMS-
Loss of vision
Floaters – weiss ring
- cobwebs
-sudden shower of minute dark
spots
Flashes

7. SIGNS
Marcus gunn pupil

IOP - lower
Tobacco dust - anterior vitreous
Mild irits

8. FUNDUS EXAMINATION
Fresh tear –
-Grey reflex instead of normal pink reflex
-Convex configuration
- Thrown into folds which move with movement of eye
Long standing RD –
-Retinal thinning
-Intraretinal cyst- 1 year
-Subretinal demarkation line – 3 months

14. INVESTIGATIONS
PERIMETRY – scotomas corresponding to
detatchment
ERG - subnormal or absent
B SCAN –in case of dense cataract

15. COMPLICATIONS
Proliferative vitreoretinopathy
Complicated cataract
Uveitis
Phthisis bulbi

16. TREATMENT
Mainly surgical
INDICATIONS OF URGENT SURGERY
Position of break
Size of break
State of vitreous gel

17. SURGICAL TECHNIQUES
Pneumatic Retinopexy
Scleral Buckling
Sub retinal fluid drainage

22. PROPHYLAXIS
Laser photocoagulation
Cryotherapy

23. TRACTIONAL RD
NSR pulled away RPE by contracting vitreoretinal
traction bands in absence of retinal break

24. ETIOLOGY
Proliferative Diabetic Retinopathy
Retinopathy of Prematurity
Penetrating injuries
Sickle cell retinopathy
Eales disease

25. CLINICAL FEATURES
Vitreoretinal tractional bands
Configuration of detatched area is concave

26. TREATMENT
Pars Plana Vitrectomy

27. EXUDATIVE RD
Caused neither by a break nor traction
Sub retinal fluid derived from fluid in vessels of NSR or
choroid

28. ETIOLOGY
Choroidal tumours - melanomas , haemangiomas ,
metastasis
Inflammation – VKH , posterior scleritis
 CSR
Choroidal neovascularisation
Hypertensive choroidopathy
Idiopathic

29. CLINICAL FEATURES
SYMPTOMS-
Floaters
Photopsia is absent
Visual field defect
SIGNS-
RD - convex configuration but smooth surface
Shifting fluid
Leapord spots

30. TREATMENT
Spontaneous regression
Treat the cause
Intra ocular tumours - Enucleation

31. THANK YOU