appropriate tx?
a. Pan retinal photocoagulation
b. Peripheral iridectomy
c. Scleral buckling
d. Spectacles
e. Surgical extraction of lens
answer: C, it is retinal detachment, risk factors for it include myopia
if the patient was hyperopic/small eye, we would suspect closed angle gluacoma
Treatment of retinal detachment
• prophylactic: symptomatic tear (flashes or floaters) can be sealed off with laser/cryotherapy, with
the goal of preventing progression to detachment
• therapeutic
rhegmatogenous
- scleral buckle procedure or pneumatic retinopexy
- subsequent treatment with cryotherapy or laser to create adhesions between the RPE and the neurosensory retina
- vitrectomy plus injection of gas or silicone oil in cases of recurrent detachment
- vitrectomy ± membrane removal/scleral buckling/injection of intraocular gas or silicone oil as necessary
- treat underlying cause
n.b.
• pneumatic retinopexy: intraocular injection of air or an expandable gas in order to tamponade a retinal break for repair of RD
• scleral buckle: a silicone band is secured on the outside of the globe that indents the eye wall, thereby relieving vitreous traction on the retina around any tears/holes and allowing the tears/holes to remain sealed for repair of RD
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