Internal Medicine

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

1296 Restless Legs Syndrome Rhegmatogenous Retinal Detachment

management

■General measures: increase exercise

specific therapy

■Indications: symptoms that interfere significantly w/ lifestyle

➣L-dopa/carbidopa

➣Dopamine agonists (pramipexole, ropinirole)

➣Opiods: propoxyphene or oxycodone in combination w/ L-dopa

or dopamine agonists

follow-up

■Periodically depending on response to treatment

complications and prognosis

■Chronic disorder often responsive to treatment

RHEGMATOGENOUS RETINAL DETACHMENT

PATRICK M. MONAHAN, MD

history & physical

History

■High myopia.

■Cataract surgery.

■Trauma – blunt or perforating.

■Inflammation.

Signs & Symptoms

■New floaters.

■Flashing lights – Small arcs lasting only seconds.

■Visual field deficit in one eye – possibly progressive.

■Vision decreased – very mild to severe.

■Usually painless.

■Visual acuity – normal to severe decrease,

■Afferent papillary defect – none to very positive.

■Slit Lamp Exam – Pigmented debris in anterior vitreous behind lens.

■Intraocular pressure – usually normal, but can be decreased or ele-

vated in longstanding detachments.

■Posterior exam – new detachments appear as white elevated mobile

retina. Old detachments may be clear or taut. Optic nerve looks pink

to white. Retinal vessels usually normal or tortuous. Vitreous may

contain blood or debris.