Wednesday, August 8, 2012

Pathophysiology - Retinal Detachment

RETINAL DETACHMENT – is separation of the retina from the underlying layer of blood vessels

Causes
  • Trauma
  • Retinal degeneration
  • Tumor in the eye
  • Haemorrhage
  • Cataract surgery
  • Myopia
Signs and Symptoms
  • Painless blurring of vision
  • Shadows falling across the visual field
  • Floating spots
  • Flashes of lights before the eyes
Diagnostic study
  • Opthalmoscopic examination
Management
  • Provide bed rest
  • Cover both eyes
  • Speak before approaching
  • Position head as prescribed
  • Protect from injury
Surgical procedures
  • Cryosurgery – a supercooled probe is touched to the sclera causing minimal damage, as a result of scarring, the pigment epithelium adheres to the retina.
  • Photocoagulation – a light beam is passed through the pupil, causing a small burn and producing exudate between the pigment epithelium and retina
  • Electrodiathermy - an electrode is passed through the sclera to allow subretinal fluid to escape. An exudate forms from the pigment epithelium and adheres to the retina
  • Scleral buckling – a technique whereby the sclera is shortened to allow a buckling to occur, which forces the pigment epithelium closer to the retina
Post-Op Nursing Management
  • Bilateral eyepatch
  • Bed rest for 1-2 days
  • Expect redness and swelling of the lids and conjunctiva
  • Monitor for haemorrhage
  • Monitor intra ocular pressure (IOP) for the first 24 hours
  • Encourage deep breathing but not coughing
  • Limit reading for 3-5 weeks
  • Wear dark glasses during the day

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