RETINAL DETACHMENT

• Detachment of the sensory retina from the pigment epithelium of the retina;

• Tear in the retina allows the vitreous humor to seep behind the sensory retina
and penetrate it;

• Causes:

- Aging > common after age 40;

- Severe myopia

- Post-cataract extraction

- Diabetic retinopathy

SSx:

• Sudden flashes of light

• Sudden visual field loss (client reports the sensation of shade or curtain
coming across the vision of the involved eye)

• Sensation of particles moving in his line of vision (sudden onset of

numerous floaters)

• Blurred vision that becomes progressively worse.

Surgical Management:

• Attempt to reattach the sensory retina to the retinal pigment epithelium;

1. Laser photocoagulation surgery

- A laser is used to burn the edges of the tear and stop progression;
 2. Scleral bulking

- Place the retina back in contact with the choroid;

- The sclera is depressed from the outside using silicone sponges or

bands;

3. Cryopexy

- Use of nitrous oxide to freeze the tissue behind the retina tear to
promote scar formation the will seal the edges of the tear;

4. Pneumatic Retinopexy

- Most effective for detachments in the upper portion of the eye;

- A small gas bubble is injected into the vitreous body;

- The bubble rises or floats against the retina, pushing it against the
choroid;

- The bubble is absorbed after 1-2 weeks, then laser or cryopexy will
seal the tear

Pre-Op Care:

• Instruct the patient to remain quiet in prescribed (dependent) position, to

keep the detached area of the retina in dependent position.
• Patch both eyes.
• Wash the patient’s face with antibacterial solution.
• Instruct the patient not to touch the eyes to avoid contamination.
• Administer preoperative medications as ordered.

Post-Op Care:

• Observe for hemorrhage.

• Maintain bed rest for 1-2 days.

• Use of eye shield at night.

• No bending from waist or lifting heavy objects for 6 weeks.

• Avoid reading for 3 weeks or more.

• Avoid straining and constipation.

Retinal Detachment
 Submitted by:

Castro, Jonathan M.