What questions should be asked with a potential Retinal Detachment?

From the Guidelines

When evaluating a potential case of retinal detachment, healthcare providers should ask the patient a series of key questions to assess the likelihood of retinal detachment, its potential causes, and any risk factors that may complicate treatment, as outlined in the posterior vitreous detachment, retinal breaks, and lattice degeneration preferred practice pattern 1.

These questions include:

• Have you noticed any sudden changes in your vision, such as flashes of light, floaters, or a curtain-like shadow in your field of vision?
• When did these symptoms start, and have they worsened over time?
• Do you have a history of eye conditions, particularly myopia (nearsightedness) or previous retinal detachment?
• Have you had any recent eye surgeries or injuries?
• Do you have any systemic conditions like diabetes or hypertension?
• Have you experienced any recent head or eye trauma?
• Are you experiencing any pain or discomfort in the affected eye?
• Do you have a family history of retinal detachment?
• Have you noticed any changes in your peripheral vision?
• Are you currently taking any medications, particularly blood thinners?

These questions help identify patients at risk of developing a rhegmatogenous retinal detachment (RRD) and guide further examination and prompt intervention if necessary, with the goal of preventing visual loss and functional impairment, and maintaining quality of life 1.

The most recent and highest quality study, published in 2020 in the journal Ophthalmology 1, emphasizes the importance of early detection and treatment of retinal detachment to prevent vision loss and maintain quality of life.

Key points to consider when evaluating a patient with potential retinal detachment include:

• The symptoms of posterior vitreous detachment (PVD), such as flashes of light and floaters, which can increase the risk of retinal detachment 1
• The importance of a thorough peripheral examination to detect retinal tears or holes 1
• The need to consider other causes of vitreous cells or debris, such as uveitis, infection, inflammation, or neoplasia 1
• The role of lattice degeneration and retinal breaks in increasing the risk of retinal detachment 1
• The importance of prompt treatment of symptomatic retinal breaks to prevent retinal detachment 1

By asking these key questions and considering these important points, healthcare providers can provide timely and effective care to patients with potential retinal detachment, reducing the risk of vision loss and maintaining quality of life.

From the Research

Questions to Ask with a Potential Retinal Detachment

When dealing with a potential retinal detachment, several questions should be asked to ensure proper diagnosis and treatment. These include:

• What are the symptoms experienced by the patient, such as vision loss, floaters, or flashes of light? 2
• Has the patient experienced any recent trauma or injury to the eye?
• Are there any underlying medical conditions, such as diabetes or high blood pressure, that could contribute to retinal detachment?
• Has the patient recently undergone any surgical procedures, including dental procedures, that could potentially lead to vision loss? 3
• Are there any signs of retinal ischemia, such as transient monocular vision loss, which could indicate a higher risk of cardiovascular events and death? 4, 5
• Has the patient recently given birth, as vision loss can be a symptom of postpartum complications such as HELLP syndrome? 6
• What is the patient's medical history, including any previous eye problems or conditions that could increase the risk of retinal detachment?

Importance of Prompt Medical Attention

It is essential to ask these questions to determine the cause of the potential retinal detachment and to provide prompt medical attention. Retinal detachment can lead to permanent vision loss if left untreated, and prompt treatment can significantly improve outcomes. 4, 5

Clinical Evaluation

A thorough clinical evaluation, including a detailed history and examination, is crucial in guiding further tests and determining the best course of treatment. 2

Risk of Cardiovascular Events

Patients with retinal ischemia as the etiology of transient monocular vision loss are at high risk of cardiovascular events and death, and should have an urgent ophthalmologic examination and stroke prevention protocol initiated. 5