Sunday, December 19, 2010

Risk factors for retinal detachment

-Which of the following is considered a risk factor for retinal detachment? 
A) Glaucoma
B) Diabetic retinopathy
C) Hyphema
D) Myopia

Answer and Discussion
Retinal detachment is a preventable cause of vision loss. It is relatively common after the age of 60. There are three types of retinal detachments: exudative, tractional, and rhegmatogenous. The most common type is rhegmatogenous, which results from retinal breaks caused by vitreoretinal traction.
Exudative (or serous) retinal detachment results from the accumulation of serous and/or hemorrhagic fluid in the subretinal space because of hydrostatic factors (e.g., severe acute hypertension), or inflammation (e.g., sarcoid uveitis), or neoplastic effusions. Exudative retinal detachment generally resolves with adequate treatment of the underlying disease, and restoration of normal vision is often excellent. Tractional retinal detachment occurs via centripetal mechanical forces on the retina, usually mediated by fibrotic tissue resulting from previous hemorrhage, injury, surgery, infection, or inflammation.

Risk factors for retinal detachment include advancing age, previous cataract surgery, myopia, and trauma. Other eye conditions including hyphema, glaucoma, and diabetic retinopathy are not considered risk factors for retinal detachment.
Patients typically present with symptoms such as light flashes, floaters, peripheral visual field loss, and blurred vision. Retinal tears may occur without symptoms, but often photopsia (light flashes) is noted. Photopsia results from vitreoretinal traction. When the retina tears, blood and retinal pigment epithelium cells may enter the vitreous cavity and are perceived as “floaters.” Immediate intervention can prevent retinal detachment. Patients with the acute onset of flashes or floaters should be referred to an ophthalmologist.
The answer is D.

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