Rhegmatogenous retinal detachment in young adults

Purpose: A retrospective study was conducted to assess the etiological factors for rhegmatogenous retinal detachment [RRD] and the visual and anatomical outcome of treatment in a group of young Saudi adults.Methods The records were retrieved of all patients aged between 14 and 40 years who had been treated by the authors for RRD from October 1991 to October 1994 to at the King Abdul Aziz University Hospital in Riyadh, Saudi Arabia. All patients aged between 14 and 40 years who had attended at least two postoperative follow-up visits were included in the study. The etiology, treatment, and visual and anatomic outcome of treatment were recorded Fellow eye pathology and management were also evaluated. The final study group comprised 74 patients [63 males and 11 females] aged from 14 to4O years [mean, 31.8 +/- 5.4 years]. Twenty-three patients [31.1%] presented with RRD secondary to retinal breaks associated with lattice degeneration; retinal detachment [RD] was bilateral in seven of these patients. All patients were myopic before treatment, ranging from -1.0 to -12.0 diopters [D] [mean -7.4 +/- 3.2 D]. The fellow eye needed prophylactic treatment. Twenty-one patients [28.4%] had trauma-related detachments. RRD due to atrophic holes without other pathology was noted in 13 patients [17.6%]. Refraction ranged from +0.5 to -19.0 D [mean, -90 +/- 7.4 D]. RRD due to horseshoe tears was found in seven patients [9.5%]. Their refraction ranged from -43.5 to -23.0 D [mean -9.9 +/- 8.2 D]. Five patients [6.7%] were found to have RRD secondary to giant breaks. The refraction s between -8.0 to -14.0 D [mean -11.2 +/- 2.04 D]. Two patients [2.7%] had aphakic RRD following surgery for congenital cataract. Another two patients [2.7%] had rhegmatogenous retinal detachment following pars planavitrectomy. Choroidal colohoma was found in one patient [1.3%]. In all groups there was a male predominance. Conclusion Lattice degeneration and trauma were the most important causes of RRD in young Saudi adults. Patients with lattice degeneration-related RRD had the most favorable surgical and functional outcome. RRD is frequently a bilateral disease in all etiologie groups except trauma

Combined central retinal artery and central retinal vein obstruction after retrobulbar anesthesia

Retrobulbar anesthesia is the most common anesthetic procedure in ophthalmology. Although it is rarely associated with serious problems, a considerable number of complications have been reported. One of these is retinal vascular occlusion, which can have devastating visual sequelae. To our knowledge, only 11 cases of combined obstruction of the central retinal artery and central retinal vein, secondary to retrobulbar anesthesia, have been reported previously. We present an additional such case which resulted in permanent blindness. Possible mechanisms are discussed, as well as alternative techniques of local anesthesia that might decrease the incidence of complications associated with retrobulbar injections