Know what happens between referral and return visit

Optometrists who co-manage patients who have had retinal detachments may want to book a date with a retinal surgeon.

New York-Optometrists who co-manage patients who have had retinal detachments may want to book a date with a retinal surgeon. Watching a retinal surgeon perform a retinal reattachment firsthand is a valuable way for optometrists to improve their post-operative management of these cases, said David M. Krumholz, OD, FAAO, associate professor, State University of New York College of Optometry. Dr. Krumholz was speaking here at Vision Expo East.

Recognizing detachment

After identifying a retinal detachment and referring the patient to a retinal specialist, ODs should be prepared to receive back a patient who has had permanent changes made to his or her eye.

"Most ODs typically co-manage a large number of cataract patients," Dr. Krumholz said, "but retinal reattachment is a more extensive and invasive procedure that involves much more manipulation of the eye than does a routine cataract removal.

"For example," he continued, "the surgeon performing the retinal reattachment will often sew a piece of silicone plastic underneath the conjunctiva. If you understand the procedure, you'll know when you get the patient back that the little bump you're seeing is a scleral buckle and it's normal."

The medications that will be prescribed by the surgeon are also going to be heavier for retinal reattachment patients compared with those who have had a cataract removed.

Dr. Krumholz said that while the specific regimen will vary by surgeon, patients who have had a retinal reattachment are going to be taking an antibiotic for 1 week to 10 days, an anti-inflammatory agent for 6 weeks, and a mydriatic cycloplegic for at least a week. Patients might also be taking agents to lower their IOP.