Retinal Detachment
 
Note: The majority of the cases has treated retinal detachment possibly with proliferative vitreoretinopathy (PVR). Otherwise, the patient may be an in-patient awaiting surgery (the wearing of hospital pyjama may provide the clue). Another favorite case is long-standing retinal detachment usually with watermark.

In treated retinal detachment, there is/are area(s) of chorioretinal atrophy with indentation from cryotherapy and explant. Examine the conjunctiva and comment if the explant is secured. Look for wrinkling of the retinal surface, vessel tortusosity and retinal folds suggesting the development of PVR. Examine the opposite eye for lattice degeneration and cryo/photocoagulation scars.

Note presence of other predisposing factors:

  • aphakia
  • high myopia
  • Marfan's syndrome
  • Sticker's syndrome
In chronic retinal detachment, the margin of the retina contains water marks with hyperp-igmentation. The surface may contain fibrous tissue. Look for retinodialysis which is a common cause of chronic inferior retinal detachment.

Questions:
1. List the risk factors for retinal detachment


 

2. What is lattice retinal degeneration?


 

3. What is proliferative vitreoretinopathy and how is it classified?

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Lattice degeneration

Enlarged view of lattic degeneration showing
hyalined retinal blood vessels
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Proliferative vitreoretinopathy
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Watermarks in chronic retinal detachment
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