December 27, 2013 | POSTED BY | Clinical Optometry, Clinical Pearls
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Retinal detachments can be scary and potentially sight-threatening. It can sometimes feel overwhelming to educate your at-risk patients about what symptoms they may experience. To keep things simple, just remember to talk to your patient about the following five symptoms of a retinal detachment:

1)      Flashes of light or new floaters

2)      Curtain over vision approaching from any direction

3)      Red tinge to vision

4)      Dark spots in vision

5)      Blurry vision

An IOL-induced retinal detachment.

When is it necessary to educate your patient about the symptoms of a retinal detachment? You should definitely considering doing so when your patient has any of the following risk factors, which are organized based on the most likely etiology of the detachment:

Rhegmatogenous Retinal Detachment

  • Lattice degeneration
  • Posterior vitreous detachment
  • Myopia (higher myopia = higher risk for RD)
  • Trauma
  • Previous ocular surgery (especially with vitreous loss) – e.g., cataract surgery
  • Positive family or personal history

Retinal detachment on ultrasound.

Serous/Exudative Retinal Detachment

  • Uveal effusion syndrome (i.e., choroidal accumulation of fluid)
  • Vogt–Koyanagi–Harada syndrome
  • Choroidal tumor
  • Central serous retinopathy
  • Posterior scleritis
  • Coats’ disease
  • Hypertensive retinopathy
  • Optic nerve pit
  • Retinal coloboma

Choroidal melanoma in a patient with a history of plaque therapy.

Tractional Retinal Detachment

  • Toxocariasis
  • Diabetic retinopathy
  • Sickle cell
  • Retinopathy of prematurity
  • Proliferative vitreoretinopathy
  • Familial exudative vitreoretinopathy

High-risk non-proliferative diabetic retinopathy.

The retinal detachment may not be noticed by the patient until the macula becomes involved, so increasing the vigilance of the patient by conveying the common symptoms is vital to catching the detachment as early as possible. Make sure that your patient knows to return to your office as soon as possible if they notice any of the symptoms you mention!

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