Biography
Biography: Amrita Verma
Abstract
The rhegmatogenous retinal detachments in the pediatric age group is uncommon with an annual incidence of 0.38–0.69 per 100,000, making up only 0.5–8% of all retinal detachments. The median ages of presentation reported are 9–13 years of age. The aetiologies encompass trauma, idiopathic, inherited syndromes associated with high myopia and abnormal vitreous, atopic dermatitis, congenital and developmental abnormalities, retinal vascular diseases and intraocular inflammation. A complete ophthalmic evaluation is preferably done under anesthesia. Full systemic workup by a pediatrician is also often required. The surgery for pediatric detachments is challenging. The rate of retinal reattachment with single intervention is considerably low at 50–80%. Visual outcomes are also worse in children with most series showing only 30–40% of patients reaching a final acuity of 20/200–20/400. Patients with congenital and developmental abnormalities have worse anatomical and functional outcomes than patients who had no predisposing factor or high myopia. Other risk factors for poor outcome are macular involvement, the presence of PVR, the presence of giant retinal tear, and inability to determine pre-operative acuity. Multiple surgeries are often required. Especially in younger children the importance of refraction and amblyopia therapy cannot be over emphasized. While visual outcomes are poor compared to the adult population, the high rate of bilateral detachments, as well as, the importance of even low levels of vision in these patients mean that the repair of these detachments pose unique challenges to the surgeon and the family.