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choroidal detachment
separation of the choroid from the sclera
Etiology:
- surgery (most common)
- trauma
- panretinal photocoagulation
- corneal ulcers
- globe hypotony (serous)
- ocular inflammation (serous)
Pathology:
- serous:
- transudative fluid accumulation in the potential suprachoroidal space
- hemorrhagic:
- hemorrhage in the suprachoroidal space or within the choroid caused by the rupture of choroidal vessels
- separation of the choroid from the sclera
Clinical manifestations:
- spontaneous (serous)
- generally painless
- variable visual impairment
- post surgical (hemorrhagic):
- sudden excruciating throbbing pain
- immediate loss of vision
Special laboratory:
- B-scan ultrasonography
- tonometry for intraocular pressure
Differential diagnosis:
- acute angle-closure glaucoma
- ocular melanoma
- pupillary block
- retinal detachment
Complications:
- retinal detachment
- maculopathy
- globe phthisis
- visual impairment (40%)
Management:
- topical corticosteroids
- cycloplegics
- mydriatics
- oral steroids may be indicated for ocular inflammation
- lower intraocular pressure if elevated
- acetazolamide (carbonic anhydrase inhibitor)
- timolol
- mannitol
- parasympathomimetics are contraindicated
- pilocarpine contraindicated
Related
choroid
General
choroid disease
References
- Traverso CE
eMedicine (Medscape): Choroidal Detachment
http://emedicine.medscape.com/article/1190349-overview