Assessment

HISTORY. Patients with suspected retinal detachment complain of a painless change in vision. Ask the patient if he or she has experienced "floaters" or black spots, flashing lights, or the sensation of a curtain being pulled over the field of vision. Some patients report feeling as if they are looking through a veil or through cobwebs. Ask the patient if he or she recently experienced any eye trauma.

PHYSICAL EXAMINATION. A thorough visual examination is done to detect changes in vision. Inspect the retina with an ophthalmoscope to determine the extent of the tear. Assess the patient's ability to ambulate safely and to perform the normal activities of daily living.

PSYCHOSOCIAL. Ifthe patient is still employed rather than retired, determine the effect of visual impairment on the patient's ability to perform the job. Determine the effects of visual changes on leisure activities. Assess the patient's support system, access to healthcare, and financial resources.

Diagnostic Highlights

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