Scleral Depresssion Exam

[curio255]

Is it possible for a scleral depression exam to reattach the vitreous to the retina after a PVD has occurred?

[curio255]

Okay, thank you doctor.

[John C Hagan III, MD, FACS, FAAO]

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[curio255]

Thank you for your response doctor. While I do not feel that the cardiologist analogy is applicable here, I do appreciate your input.

I was also unaware of other's assertions about scleral depression exams causing retinal detachment. I thought of this possibility independently, as all of the notes of the RS, only 2 days prior to my detachment, indicated healthy eyes with PVD already complete. It is just a strange coincidence I guess.

[John C Hagan III, MD, FACS, FAAO]

It happens often because of the high risk of RD in the nature of the complaint

[curio255]

Thank you for you response doctor. I ask because I went to see a retina specialist 2 days before my retina detached and he said, after all the scans and his physical examination, that I had "very healthy eyes".  He also noted that PVD was complete in my left eye. But then he performed a pretty hard scleral depression exam and 2 days later my retina detached. I was very surprised that this happened, especially after just seeing him and him and saying that the PVD was complete. It seemed to me that he may have pressed the vitreous back on the retina with his hard pressing on my eye and 2 days later it just snapped off and caused the detachment.

[John C Hagan III, MD, FACS, FAAO]

It does not meet the standard of care for a possible RD or acute PVD not to closely examine the peripheral retina where most breaks or holes develop.  As a PVD develops it may take 6-12 weeks for some people for the vitreous to peel over the retina.  This is a very high risk group of patients and often the RD comes after the exam/scleral exam done initially.  If you went to a cardiologist and they pushed hard on the stethascope or your abdomen and 3-4 days later you had a heart attack would you blame the cardiologist for doing a thorough exam earlier.  Same situation

[John C Hagan III, MD, FACS, FAAO]

No nor does scleral depression cause retinal detachments as some people posting here in the past have asserted