Retinal detachment

BSC NURSING III YEAR/ MEDICAL SURGICAL NURSING II

1. RATINAL DETACHMENT Mr. Manikandan.T , RN., RM., M.Sc (N)., D.C.A .,( Ph.D ) Assistant Professor, Dept. of Medical Surgical Nursing, VMCON, Puducherry .

2. RATINALDETACHMENT R etinal detachment refers to the separation of the RPE from the sensory layer. It is separation of the sensory retina and the underlying pigments, with fluid accumulation between the two layers. Detached retina

3. Types Rhegmatogenous detachment . Traction retinal detachment . Exudative retinal detachments . Combination of rhegmatogenous and traction, and exudative.

4. Rhegmatogenous detachment In this condition, a hole or tear develops in the sensory retina, allowing some of the liquid vitreous to seep through the sensory retina and detach it from the RPE

5. Traction retinal detachment . Tension, or a pulling force, is responsible for traction retinal detachment, patients develop scar tissue.

6. Exudative retinal detachments It occurs as a result of the production of a serous fluid under the retina from the choroid. Conditions such as uveitis and macular degeneration may cause the production of this serous fluid.

7. Risk factors Increasing age. Severe myopia. Eye trauma. Retinopathy (diabetic). Cataract or glaucoma surgery. Family history . Personal history .

8. Flow chart shows Separated retinal layer

9. Pathophysilog y Aging, eye trauma Retina tears and pulls retina Break retina, liquid viteous can enter the subretinal space between the sensory layer and the retinal pigment enithelium layer Rhegmatogenous retinal detachment.

10. Clinical manifestation Photopsia Visual loss Floaters and a cobweb hairnet or ring in the field of vision Painless loss of peripheral or central vision

11. Diagnostic evaluation History and physical examination visual acuity measurement. Opthalmoscopy . Slit lamp microscopy. Ultrasound of cornea, lens or citreous is lazy or opaque.

12. Medical management Mydriatic , cycloplegic Photocoagulation of retnial break

13. Surgical management Laser photocoagulation: It seal retinal break by creating an inflammatory reaction to causes a choriretinal adeshion or scar. Cryoretinopexy : Sclera blocking Vitrectomy Draining of subretinal fluids.

14. Preoperative nursing inteventions Provide emotional support to the patient who may be distraught at the potential loss of vision Prepare the patient for surgery by cleaning his face and giving him antibiotics and eyedrops , as ordered Teach the patient for surgery by cleaning his face and giving him antibiotics and eyedrops , as ordered Teach the patient about the role of the retina and why floaters, flashes of light, and decreased vision occur. Allow the patient and family to discuss their concerns