Delay in Presentation of Patients With Retinal Detachment Primarily Due to Lack of Knowledge

Abstract

Purpose: : The time interval between presentation and operation of patients with a retinal detachment involving the macula is a critical variable that should be minimized, since it strongly determines functional outcome. The goal of this survey therefore was to analyze the reasons for delay in presentation of patients with symptoms of primary rhegmatogeneous retinal detachment (RRD).

Methods: : Questionnaires filled in by consecutive patients with a primary RRD between June 2006 until June 2007 were evaluated for reasons in the delay in presentation. Delay in time was evaluated for the patient, the general practionar (GP), the referring ophthalmologist, access to at the outpatient department, and time until the actual operation took place.

Results: : Questionnaires were completed by a total of 205 patients (206 eyes). The mean overall delay between the first symptoms noted by the patient and the moment of operation was 24 days. The mean delay of the patient was 11.1 days (SD ± 23.9 days), while the mean delay due to the general practitioner (GP) was 5.3 days (SD ±20.0 days). More than half of the patients had a delay due lack of knowledge. The mean patient delay was significantly lower in patients with a vitreous hemorrhage (mean delay 1 day) and in patients with a history of a RRD in the fellow eye (mean delay 3 days).

Conclusions: : The major reason for delay in presentation in patients with a RRD was the patients’ lack of knowledge and unfamiliarity with the symptoms of a RRD. Patient education may therefore be a primary goal to improve functional outcome after RRD surgery.

Keywords: retinal detachment • visual acuity • clinical (human) or epidemiologic studies: risk factor assessment