Diagnosis
An ophthalmic assessment is necessary when a patient presents with symptoms and risk factors suggesting retinal breaks or detachment (1).
The diagnosis of a retinal detachment may require:
- Direct ophthalmoscopic examination:
- loss of red reflex (caused by retinal detachment or vitreous haemorrhage)
- retinal detachments near the macula can be seen
- detached retina may appear as pale, opaque, and wrinkled with absent normal choroidal pattern
- Visual acuity testing:
- should be done before the pupil is dilated
- reduced acuity is caused by:
- macular detachment
- vitreous haemorrhage
- Relative afferent pupillary defect is seen in extensive retinal detachment
Due to its narrow field of view a normal examination with direct ophthalmoscopy cannot be used to exclude retinal detachment. Slit lamp or indirect ophthalmoscopy with a consdensing lens should be used to detect retinal breaks in the peripheral retina (1). This will usually require an ophthalmological referral.
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