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Running Header: Retinal Detachment

Retinal Detachment
Jonathan Bland
Pathophysiology
Professor Lori McGowan

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Mr. Ally went to the eye doctor and complained about dark areas in his vision. He
had never noticed it before. There is no pain. The patient could be diagnosed with
retinal detachment. The retina is a thin sheet of light sensitive nerve tissue lining the
inside of the eye. It is the tissue that turns light INTO an electrical signal to send to the
brain. It can be compared to the film in a camera (Kim & Loewenstein, 2011).
Most people with notice floaters and flashes before the retina detaches. As the
detachment occurs, a gradually enlarging dark area may be seen. Some people have
compared this to a curtain coming down, or a shade being drawn in front of the eye. The
dark area may begin in any part of the field of vision. If the dark area reaches the center
of the field of vision, the eye will not be able to see fine detail (Kim & Loewenstein,
2011). The floaters are tiny particles drifting across the eye. Although they are brief and
harmless they may be the first sign of retinal detachment.
Retinal detachments are often associated with a tear or hole in the retina through
which eye fluids may leak. This causes separation of the retina from the underlying
tissues. As the detachment occurs a gradually enlarging dark areas may be seen. (Kim
& Loewenstein, 2011). Also, during a retinal detachment, bleeding from small retinal
blood vessels may cloud the interior of the eye, which is normally filled with vitreous
fluid. Central vision becomes severely affected if the macula, the part of the retina
responsible for fine vision, becomes detached. The patient may have bright flashes or
light, blurred vision, floaters in the eye, shadow or blindness in a part of the visual field
of one eye.

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The doctor can confirm the retinal detachment with certain tests, which include:
electroretinogram, fluorescein angiography, intraocular pressure determination,
ophthalmoscopy, refraction test, retinal photography, visual acuity, slit-lamp
examination, and an ultrasound of the eye.
The doctor can treat Mr. Ally, with several different types of surgery. Cryopexy,
(intense cold applied to the area with an ice probe) to help a scar form, which holds the
retina to the underlying layer. In addition, laser surgery to seal the tears or holes in the
retina; pneumatic retinopexy (placing a gas bubble in the eye) to help the retina float
back into place. Laser surgery is performed after pneumatic retinopexy to permanently
fix it in place. More extensive detachments may require surgery in an operating room.
Those include: scleral buckle to indent the wall of the eye and vitrectomy to remove gel
or scar tissue pulling on the retina (Griggs, 2009).

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Works Cited
Gould, B. E. (2006). Pathophysiology for the Health Professionals, 3rd Edition.
Philadelphia: W.B. Sauders.
Griggs, P. (2009, Aug 6). Retinal Detachment. Retrieved April 21, 2011, from PubMed
Health : http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002022/
Kim, R. M., & Loewenstein, J. M. (2011, April 11). Retinal Detachment. Retrieved April
21, 2011, from Digital Journal of Opthalmology:
http://www.djo.harvard.edu/site.php?url=/patients/pi/435