Retina and Vitreous

Comprehensive ophthalmologists and vitreoretinal specialists must be particularly diligent when managing patients with vitreoretinal diseases. Practically every vitreoretinal diagnosis has the potential for severe visual impairment or blindness. It can be further expected that a significant number of patients will experience profound, irreversible visual loss as a result of their disease before or despite successful treatment. Our best efforts cannot prevent a percentage of the treatment we provide from being unsuccessful. The devastating visual prognosis of most of vitreoretinal diseases virtually ensures a poor visual result after failed treatment.

Patient education regarding risks during the informed consent discussion thus acquires even greater significance when managing patients with these diseases. Mention should be made of the possibility of no visual improvement or further vision loss despite successful therapy. It is of paramount importance that an optimal physician–patient relationship is established and nurtured throughout the course of treatment. This is often difficult because of the abrupt manifestation of symptoms of many vitreoretinal diseases, such as central retinal artery occlusion, retinal tear, retinal detachment, endophthalmitis, and intraocular foreign bodies, which usually require expeditious treatment the day of the first visit. In these circumstances, there is insufficient time to establish as strong a relationship as would be possible prior to an elective procedure. Patient apprehension in such situations can make comprehension of pertinent details less reliable.