Uttarakhand CHO - 2021
Medical & Surgical Nursing
Easy
What is the most common cause of Retinal Detachment?
Appeared in: Uttarakhand CHO - 2021
Explanation
- The most frequent type of retinal detachment is rhegmatogenous, which is caused by a full-thickness break or tear in the retina.
- This tear most commonly results from age-related degenerative changes, specifically a posterior vitreous detachment (PVD), where the vitreous gel shrinks and pulls on the retina.
- Liquefied vitreous humor then seeps through the retinal defect, separating the neurosensory retina from the retinal pigment epithelium (RPE).
- Risk factors that weaken the retina and predispose it to tears include high myopia (nearsightedness) and lattice degeneration.
Why Other Options Were Wrong
- Option A: Diabetes mellitus causes tractional retinal detachment, where fibrovascular scar tissue contracts and pulls the retina. While a serious complication of diabetes, it is less common than rhegmatogenous detachment.
- Option B: Brain tumors are not a direct or common cause of retinal detachment. They can cause other ocular signs like papilledema from increased intracranial pressure.
- Option D: While direct trauma to the eye can cause a retinal tear and subsequent rhegmatogenous detachment, it accounts for a smaller proportion of cases compared to spontaneous, age-related degenerative changes.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Etiology and Types of Retinal Detachment as background academic context rather than a clinical decision trigger.
- A nurse must recognize the hallmark symptoms of retinal detachment: a sudden increase in floaters, photopsia (flashes of light), and a shadow or 'curtain' descending over the field of vision.
- Retinal detachment is a medical emergency. Immediate referral to an ophthalmologist is critical to prevent permanent vision loss. The patient should be advised to rest and limit eye movement.
- Post-operative nursing care after retinal reattachment surgery involves maintaining a specific head position (e.g., prone or on one side) to allow the gas bubble or silicone oil to press the retina back into place.
How to Approach the Question
- First, identify the core of the question: it asks for the 'most common' cause of retinal detachment.
- Recall the main types of retinal detachment: rhegmatogenous, tractional, and exudative.
- Associate each type with its primary cause: rhegmatogenous (tear), tractional (pulling/scar tissue), and exudative (leaking fluid).
- Consider the options provided. 'Degenerative changes' relate to the aging process that leads to retinal tears (rhegmatogenous). 'Diabetes' relates to scar tissue (tractional). 'Trauma' can cause a tear. 'Brain tumours' are not a direct cause.
- Compare the prevalence. Age-related degenerative changes causing rhegmatogenous detachment are the most frequent cause overall.
- Select the option that reflects this most common pathway.
Concept Tested & Keywords
- Concept Tested: Etiology and Types of Retinal Detachment
- Stem keywords: Retinal Detachment, most common cause
- Lead-in keywords: What is
Question ID
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Reference Book
E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 1317-1319
E6 Medicine Harrison 22e Part 1 pp. 272-274, 273-275
Practise the full Uttarakhand CHO - 2021
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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