Eyes & Vision

Retinal detachment

Retinal detachment separates the neurosensory retina from its support tissues and can cause permanent sight loss; new flashes, floaters, a curtain or sudden visual loss need urgent retinal assessment, especially before the macula detaches.

Definition

Retinal detachment is separation of the neurosensory retina from the retinal pigment epithelium and its supporting tissues. Rhegmatogenous detachment follows a retinal break, while tractional and exudative detachments have different mechanisms; all suspected detachments require urgent ophthalmic assessment.

First principles

Rhegmatogenous detachment is a tear-and-fluid problem

The common rhegmatogenous form occurs when vitreous traction creates a retinal break and liquefied vitreous passes behind the neurosensory retina. The retina then lifts away from the retinal pigment epithelium and choroidal support. Tractional detachment is pulled up by fibrovascular scar tissue, while exudative detachment is driven by fluid without a retinal break; the distinction matters because treatment is different.

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