Retinal detachment and the second stage of labour: a survey of regional practice and literature review.

Following several referrals for 'assessment', obstetricians in the West Midlands Health Region were surveyed regarding patients perceived to be at high risk of retinal detachment during the second stage of labour. A questionnaire was sent to 95 practicing obstetricians. This was a four-item questionnaire, based on four identifiable categories of referral to the ophthalmologist, by the obstetricians. It also covered the perceptions of the obstetricians of the ocular problem in relation to their obstetric clinical decision. With a 70% response rate, a significant number of obstetricians consider that certain ophthalmic conditions predispose to retinal detachment during labour. Even though they hold this view, the obstetricians generally do not modify their obstetric practice in response to any perceived ophthalmic risk. Such a view is not borne out by current literature, with no evidence to support a causative link between labour and rhegmatogenous (versus serous) retinal detachment, even in eyes predisposed to that condition.