Internal Medicine

(Wang) #1

0521779407-18 CUNY1086/Karliner 0 521 77940 7 June 13, 2007 8:1


Rhegmatogenous Retinal Detachment Rheumatoid Arthritis 1299

■Proliferative Vitreoretinopathy (PVR) – uncommon, causes rede-
tachment.
➣Surgery.
■Vitreous hemorrhage – uncommon.
➣May reabsorb, if not surgery.
■Epiretinal Membrane – rare, late complication.
➣Surgery to remove.
■Choroidal detachment- rare
➣Oral predmisone, rarely surgery.
■Glaucoma permanent – rare
➣Eye drops, meds or surgery.
■Infection – rare
➣Immediate attention with antibiotics and possible surgery
■Note: Patients with infection or severe post op glaucoma are most
likely to present emergently with severe headache and nausea.

Prognosis
■Approximately 98% of new detachments are repairable with one or
two
■operations.
■Good vision is obtainable if repair is performed within one week of
central
■vision loss.
■Most complications are treatable.
■If PVR develops the risk of regrowth and redetachment may be as
high as
■50% even with successful initial surgical detachment repair.

RHEUMATOID ARTHRITIS


W. NEAL ROBERTS, MD


history & physical
History
■Sine qua non: pain in the characteristic pattern, usually small joints
of hands & feet
■1% prevalence in population, 2–5% in first-degree relatives of pts w/
RA
■∼80% female
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