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Retinal Detachment Treatment & Management

  • Author: Hemang K Pandya, MD; Chief Editor: Robert E O'Connor, MD, MPH  more...
 
Updated: Oct 20, 2015
 

Prehospital Care

When the patient or their family member contacts their physician, they should be advised to:

  • Keep the patient NPO (absolutely no solid foods or fluids) in anticipation of retinal surgery
  • In cases of associated trauma, protect the globe with metallic eye shield
  • Avoid any pressure on the globe and to limit activity to a minimum until further evaluation
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Emergency Department Care

ED treatment of retinal detachment consists of evaluating the patient and treating any unstable vital signs, preparing the patient for possible emergency surgery. Please see the examination guidelines as stated above.

Patient follow up should be based upon macula status: Whenever a macula-on retinal detachment is suspected, a retina specialist should evaluate the patient within 24 hours.

All patients should be instructed to limit strenuous physical activity. Upon discharge from the ED, patients should be provided with the name and contact information for a retina specialist located close to their home.

There exists a multitude of techniques for treating retinal detachments, including scleral buckling, pars plana vitrectomy, and pneumatic retinopexy. The retinal detachment repair is usually done on an outpatient basis.

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Consultations

Ideally, patients with RD should be quickly referred to a retina specialist. The timing of surgical intervention is typically based on the status of the macula.

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Contributor Information and Disclosures
Author

Hemang K Pandya, MD Fellow in Vitreoretinal Disease and Surgery, Dean McGee Eye Institute, University of Oklahoma College of Medicine

Hemang K Pandya, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Retina Specialists, Association for Research in Vision and Ophthalmology, Michigan State Medical Society, Michigan Society of Eye Physicians & Surgeons

Disclosure: Nothing to disclose.

Coauthor(s)

Asheesh Tewari, MD Assistant Professor, Fellowship Director, Division of Vitreoretinal Surgery, Department of Ophthalmology, Kresge Eye Institute, Wayne State University School of Medicine

Asheesh Tewari, MD is a member of the following medical societies: American Academy of Ophthalmology, Association for Research in Vision and Ophthalmology, Michigan State Medical Society, American Society of Retina Specialists, Michigan Society of Eye Physicians & Surgeons

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Robert E O'Connor, MD, MPH Professor and Chair, Department of Emergency Medicine, University of Virginia Health System

Robert E O'Connor, MD, MPH is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Association for Physician Leadership, American Heart Association, Medical Society of Delaware, Society for Academic Emergency Medicine, Wilderness Medical Society, American Medical Association, National Association of EMS Physicians

Disclosure: Nothing to disclose.

Acknowledgements

Gregory L Larkin, MD, MS, MSPH, FACEP Professor, Department of Emergency Medicine, Yale University School of Medicine

Gregory L Larkin MD, MD, MS, MSPH, FACEP is a member of the following medical societies: American College of Emergency Physicians, American Society for Bioethics and Humanities, Association for the Advancement of Automotive Medicine, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Douglas Lavenburg, MD Clinical Professor, Department of Emergency Medicine, Christiana Care Health Systems

Douglas Lavenburg, MD is a member of the following medical societies: American Society of Cataract and Refractive Surgery

Disclosure: Nothing to disclose.

References
  1. Mattioli S, Curti S, De Fazio R, Mt Cooke R, Zanardi F, Bonfiglioli R, et al. Occupational lifting tasks and retinal detachment in non-myopics and myopics: extended analysis of a case-control study. Saf Health Work. 2012 Mar. 3(1):52-7. [Medline]. [Full Text].

  2. Haimann MH, Burton TC, Brown CK. Epidemiology of retinal detachment. Arch Ophthalmol. 1982 Feb. 100(2):289-92. [Medline].

  3. Subramanian ML, Topping TM. Controversies in the management of primary retinal detachments. Int Ophthalmol Clin. 2004 Fall. 44(4):103-14. [Medline].

  4. Bjerrum SS, Mikkelsen KL, La Cour M. Risk of Pseudophakic Retinal Detachment in 202?226 Patients Using the Fellow Nonoperated Eye as Reference. Ophthalmology. 2013 Sep 8. [Medline].

  5. McNamara D. Cataract surgery may up retinal detachment risk 4-fold. Medscape Medical News. September 13, 2013. Available at http://www.medscape.com/viewarticle/811031. Accessed: September 24, 2013.

  6. Lin H, Lema GM, Yoganathan P. PROGNOSTIC INDICATORS OF VISUAL ACUITY AFTER OPEN GLOBE INJURY AND RETINAL DETACHMENT REPAIR. Retina. 2015 Oct 14. [Medline].

 
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Anatomy of the eye.
Retinal detachment. Courtesy of Kresge Eye Institute, Detroit, Michigan.
Retinal detachment. Courtesy of Kresge Eye Institute, Detroit, Michigan.
Retinal detachment. Courtesy of Kresge Eye Institute, Detroit, Michigan.
Retinal detachment. Courtesy of Kresge Eye Institute, Detroit, Michigan.
Retinal detachment. Courtesy of Kresge Eye Institute, Detroit, Michigan.
Retinal detachment. Courtesy of Kresge Eye Institute, Detroit, Michigan.
 
 
 
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