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RETINAL DISORDERS Retinal Disorders Retinal detachment Retinal hole Retinal tear Assessment Retinal Detachment: separation of retina from epithelium S & S: sudden and painless -bright flashes of light - visual field loss r/t area of detachment Risk factors: trauma, aging , tumor http://www.nei.nih.gov/health/retinaldetach/retinaldet ach.asp#5 TYPES OF DETACHMENT Rhegmatogenous: - most common; r/t mechanical force -fluid under retina Tractional: -scar tissue on retina contracts Exudative: -fluid leaks under retina SURGICAL TREATMENT Clinical setting Type of surgery -laser (photocoagulation): scar tissue formed to close the leakage -cryopexy: freezes the affected area -scleral buckling: silicone buckle sutured into sclera supports the breaks in retina Vitrectomy: vitreous removed; replaced with gas Scleral Buckling Procedure Video of Scleral Buckling http://www.youtube.com/watch?v=xQfmnA DmgLY POSTOP NURSING CARE Protect eye with patch or shield Positioning of patient -on abdomen if gas/ oil instilled in eye affected eye up Medications - antiemetics and analgesics post op - antibiotics and anti-inflammatories Patient safety - call bell/ items within reach Patient Discharge Teaching Avoid activities that promote increased IOP Avoid rapid eye movement: -reading, writing, close work Signs & Symptoms to report: -increase in pain, especially eye pain -sudden decrease in vision acuity -infection