Retinal Detachments (Cont’d)
A complete bullous retinal detachment is unmistakable in its appearance. The echoes of a highly elevated detachment appear on the ultrasonogram as a convex-shaped white reflection that extends anteriorly into the vitreous from points of attachment at the temporal and nasal ora serrata and the optic nerve, giving the appearance of a V. The V-shaped appearance of the retinal detachment will be obtained only in total retinal detachment in which the cross-section will be depicted differently.
This patient had a dense cataract that precluded view of the fundus. A total long-standing retinal detachment is evident on the ultrasonogram. He also had flat VEPs and ERGs. Surgery (cataract removal) was not recommended. This ultrasonogram is from an old Bronson-Turner unit, not commonly used today.
Total retinal detachment in which the two “leaves” of the retina have fused posteriorly that precludes the view of the disc ophthalmoscopically. There is also a cyclitic membrane that has formed anteriorly.