Contents
Separation of the neurosensory retina from the underlying retinal pigment epithelium (RPE).
Classification
Rhegmatogenous retinal detachment (RRD) (M/C form):
Retinal “break” allows the ingress of fluid from the vitreous cavity to the subretinal space, resulting in retinal separation
- Axial myopia
- Post cataract surgery (aphakia/pseudophakia)
- Yag laser capsulotomy
- Lattice degeneration of the retina
- Symptomatic (flashes/floaters) retinal tears.
- Ocular trauma
- Family history
Tractional retinal detachment (TRD):
Due to pre-retinal membrane formation and scarring that pulls the retina from its attachment
- Proliferative diabetic retinopathy (PDR)
- Proliferative vitreoretinopathy
- Retinopathy of prematurity (ROP)
- Eales’s disease
- Sickle cell retinopathy
- Trauma
Exudative/serous retinal detachments:
Subretinal fluid in absence of tear/traction
- Inflammatory (uveitis, scleritis)
- Hydrostatic (malignant hypertension, toxaemia of pregnancy)
- Neoplastic (choroidal melanoma, haemangioma, metastasis)
- Vascular (Coat’s disease, retinal macroaneurysm)
- Maculopathy (neovascular macular degeneration, central serous choroidoretinopathy)
- Congenital disorders (nanophthalmos, optic disc pit)
Presentation
- Sudden, painless loss of vision
- Field loss (loss of vision in only one part of the visual field)
- Photopsia (perception of light not attributable to an incident light)
- Not seen in exudative RD
- Floaters (perception of mobile spots, lines, or haze due to vitreous opacities)
- Mild discomfort and redness (d/t associated uveitis and hypotony)
Complications
- Proliferative vitreoretinopathy (PVR): Long-standing retinal detachments start to develop scarring that can prevent re-attachment
- Hypotony
- Pigmentary glaucoma
- New iris vessels
- Cataract
- Uveitis

Diagnosis
Binocular indirect ophthalmoscopy with scleral indentation:
- Loss of red fundus reflex
- Marked elevation of the retina

Fundus examination:

Management
If the retina is not re-attached promptly (usually less than a week after macular detachment), then visual recovery is progressively affected.
Scleral buckling:
For uncomplicated forms of retinal detachment
Vitrectomy:
For complicated retinal detachments such as those with PVR, giant retinal tears, coloboma choroid, penetrating ocular trauma, etc

Pneumatic retinopexy:
RD sealed with air insufflation
- Sulfur hexafluoride