Ver el código de «Retinal detachment»

==Background==
[[File:A Retinal Detachment.jpg|thumb|Retinal detachement]]
[[File:Ocular - Retinal detachment.gif|thumb]]
*Average age of onset ~55

===Types===
#Rhegmatogenous (rhegma means "tear")
#*As vitreous separates from retina the traction creates a hole in retina
#**Fluid goes through the hole and peels the retina off like wallpaper
#Exudative
#*Fluid accumulates beneath the retina without a retinal tear
#*Associated w/ neoplasm, inflammatory conditions, hypertension, preeclampsia
#Tractional
#*Acquired fibrocellular bands in the vitrous contract and detach the retina
#*Associated w/ DM, sickle cell, trauma
#Distinguish between mac-off and mac-on
*Other risk factors:
**Aging
**Previous retinal detachment
**Family hx of retinal detachment
**Extreme myopia
**Eye surgery, cataract removals

==Clinical Features ==
*Abrupt onset of new "floaters" or flashes of light
**Vitreous tugs on the retina before separation
*Visual acuity loss (filmy, cloudy, or curtain-like) or visual field loss 
**May be mild or dramatic 
 
==Differential Diagnosis==
{{Acute vision loss noninflamed DDX}}

{{Acute onset flashers and floaters DDX}}

==Diagnosis==
[[File:RetinalDetachment.jpeg|thumbnail]]
*Examination 
**Visual acuity and visual fields 
**Fundoscopic exam with dilation
*[Ocular ultrasound]]

==Management==
*Urgent ophtho referral within 24hr (pneumatic retinopexy, scleral buckle, or vitrectomy)<ref>Illinois Retina and Eye Associates. Retinal Detachment. 2009. http://www.illinoisretinainstitute.com/index.php?p=1_11.</ref>
*In macular off retinal detachment, visual acute is significantly decreased if reattachment does not occur within 6 days. <ref>Diederen R et al: Scleral buckling surgery after macula-off retinal detachment: Worse visual outcome after more than 6 days. Ophthalmology 2007; 114:705-709</ref>
*Position pt relative to area of retinal detachment so retina lies flat:
**Superior detachment = lay pt's head in supine position
**Inferior detachment = elevate head up
**Different from face-down recovery position after pneumatic retinopexy (so that bubble covers retinal break)
**May know where retinal detachment is by a couple of clues:
***Good fundoscopy
***US beam orientation
***[[Visual Field Defects]] examples<ref>Gariano RF and Kim CH. Evaluation and Management of Suspected Retinal Detachment. Am Fam Physician. 2004 Apr 1;69(7):1691-1699.</ref>:
****Superior detachment may have inferior visual field defect
****Temporal detachment may have nasal visual field defect

==See Also==
*[[Acute Onset Flashers and Floaters]]
*[[Ocular ultrasound]]

==References==
<references/>

[[Category:Ophthalmology]]