Operative Review of Retinal Detachment

Anatomy and physiology
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    Davao Doctor College   Gen. Malvar St.   Davao City   A Case Study of RETINAL DETACHMENT An Operative Review of PARS PLANA VITRECTOMY In Partial Fulfillment   Of NCM 103   Presented to:   Haidee L. Alferez RN, MN   Presented by:   Ken Alfred Pedreso   September 2014    CHAPTER I TABLE OF CONTENTS PAGE I. INTRODUCTION 1 II. ANATOMY 4 III. PATHOPHYSIOLOGY 7 IV. MEDICAL MANAGEMENT 8 V. DIAGNOSIS 12 VI. PROCEDURE PROPER (with Instrumentation) 15 VII. Roles of Circulating and Scrub nurse 24 VIII. Nursing Management 30 a. Nursing Care Plan i. Pre-Operative Review ii. Intra-Operative Review iii. Post-Operative Review IX. Pharmacology i. Pre-operative ii. Intra-operative iii. Post-operative X. Bibliography 37    CHAPTER I INTRODUCTION   Retinal detachment. a disorder of the eye in which the retina peels away from its underlying layer of support tissue. Initial detachment may be localized, but without rapid treatment the entire retina may detach, leading to vision loss and blindness. It is a medical emergency. The retina is a thin layer of light sensitive tissue on the back wall of the eye. The optical system of the eye focuses light on the retina much like light is focused on the film in a camera. The retina translates that focused image into neural impulses and sends them to the brain via the optic nerve. Occasionally, posterior vitreous detachment, injury or trauma to the eye or head may cause a small tear in the retina. The tear allows vitreous fluid to seep through it under the retina, and peel it away like a bubble in wallpaper. Eye after retinal detatchment    Types of Retinal Detachment ã   Rhegmatogenous retinal detachment    –  A rhegmatogenous retinal detachment occurs due to a hole, tear, or break in the retina that allows fluid to pass from the vitreous space into the subretinal space between the sensory retina and the retinal pigment epithelium. ã   Exudative, serous, or secondary retinal detachment  –  An exudative retinal detachment occurs due to inflammation, injury or vascular abnormalities that results in fluid accumulating underneath the retina without the presence of a hole, tear, or break. ã   Tractional retinal detachment  –  A tractional retinal detachment occurs when fibrovascular tissue, caused by an injury, inflammation or neovascularization, pulls the sensory retina from the retinal pigment epithelium.  A substantial number of retinal detachments result from trauma, including blunt blows to the orbit, penetrating trauma, and concussions to the head. A retrospective Indian study of more than 500 cases of rhegmatogenous detachments found that 11% were due to trauma, and that gradual onset was the norm, with over 50% presenting more than one month after the inciting injury. 2
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