ICD Oh Retina

[Jina]

Hello everyone,

I've been looking through codes under 361.3 RETINAL DEFECTS WITHOUT DETACHMENT category.
I just realized that Retinal DEFECT/ BREAK(S) is not the same thing as Retinal DETACHMENT as there are two separate codes assigned for them:
361.30 RETINAL DEFECT, UNSPECIFIED (retinal break(s) NOS)
361.9 UNSPECIFIED RETINAL DETACHMENT
So, what is the difference between the two?
Please advise

 

[Ruth Sheets]

Just by looking at the definitions, it appears that a retinal defect is an imperfection in the retina; perhaps, a fold or some abnormality that may affect the functioning of that area of the retina. A retinal detachment is defined as visual impairment resulting from the retina becoming separated from the choroid in the back of the eye.

Tip: Use a medical dictionary, online or a book version to help clarify medical terms. Sometimes it does not help, but mostly it does! I like http://medical-dictionary.thefreedictionary.com/

 

[Jina]

Hi Ruth,
My question is what exactly is the difference between "RETINAL BREAK(S)" and "RETINAL DETACHMENT."
I've encountered a lot of medical records with words "retinal detachment" over the years; I thought I knew what it means UNTIL TODAY.

I had never seen a term, retinal break(s), in medical records in all of the years I've worked in healthcare.
It was an earth shattering moment to for me when I saw the word in ICD9CM, because I started to think like "Is retina like a glass? It can break?"

I always thought I knew what retinal detachment meant, because it is kind of like a placenta detaching from the wall of the uterus.
NOW, I feel like I may have misunderstood the meaning of retinal detachment.

What is the difference between the break & detachment? Aren't they the same thing?
They clearly are not the same thing as they have different medical codes assigned to them.

What would be the difference in signs/symptoms patients may experience when patient A has retinal break whereas patient B has retinal detachment ?
How are the course of treatment differ between the two diagnoses?

You know what I mean?

 

[Ruth Sheets]

You are getting beyond the scope of my expertise, that is for sure! I Googled for some images of each. Here's a picture that shows a retinal break (tear) and a retinal detachment. http://www.retinaeye.com/retinaldetachment.html

Certainly they often occur together, but not necessarily. There were plenty of pictures that showed just one and not both.

 

[Jina]

Hi Ruth,
I don't think retinal break is the same thing as retinal tear.

Please find the attached below:
retinal break
A full thickness opening in the neurosensory retina. It may be a hole, usually due to atrophy of the retina and often overlaid by an operculum; or a tear, horseshoe-shaped (U-shaped), round or slit-like, usually caused by posterior vitreous detachment in which the vitreous adheres to the retina and pulls it from the point of adherence during or just after an abrupt eye movement; or a giant retinal tear which involves 90º or more of the circumference of the globe and is commonly associated with Marfan's syndrome or Stickler's syndrome; or retinal dialysis which is usually the result of trauma. The patient may complain of photopsia, seeing floaters or flashes and some visual field defects and they may present with a vitreous haemorrhage. Management of retinal breaks includes localized laser photocoagulation (laser retinopexy) or cryopexy, a method of cryotherapy (freezing of the tissues causing local protein denaturation which leads to adhesion of the retina to the pigment epithelium), as the defect may lead to rhegmatogenous or tractional retinal detachment.

 

[Jina]

Ooookay Ruth,
I already know about RETINAL TEAR & DETACHMENT.
The real question at hand is "What is RETINAL BREAK"?

 

[Luna]

http://medtextfree.wordpress.com/2010/12/31/chapter-135-retinal-breaks/
Might this help?

I found this insightful too. Especially under the subheading "Symptomatic Treatment."
http://www.revoptom.com/content/d/retina_report/c/24006/

I was interested in your post since I just finished a terminology chapter on the eye/adnexa.

 

[Laureen]

Jina - a retinal break is the same thing as a retinal tear - it's in the definition you pasted

retinal break
A full thickness opening in the neurosensory retina. It may be a hole, usually due to atrophy of the retina and often overlaid by an operculum; or a tear, horseshoe-shaped (U-shaped)

So a detatchment if a full pulling away and a break/tear could be a hole or tear but not completely pulled away or detached.

ICD Index Break, Retina:

ICD Index Tear, Retina

So a retina break is indexed to 361.30 which is also indexed from retinal tear WITHOUT detachment.