Retinal detachment
Retinal detachment (RD) is an ophthalmic emergency in which the neurosensory retina separates from the underlying retinal pigment epithelium. Photoreceptor function and perfusion are rapidly compromised: early recognition, accurate documentation (especially macular status) and same‑day ophthalmology review are essential to preserve vision.
Types and pathophysiology
RD is classified by mechanism; this determines likely findings and guides definitive management.
- Rhegmatogenous retinal detachment (RRD)
- Caused by a full‑thickness retinal break that allows liquified vitreous into the subretinal space.
- Most common type; often follows posterior vitreous detachment (PVD), high myopia, lattice degeneration, prior cataract surgery or trauma.
- Tractional retinal detachment
- Caused by fibrovascular membranes exerting traction on the retina (for example, proliferative diabetic retinopathy).
- There is no primary retinal break; treatment is usually pars plana vitrectomy with membrane removal.
- Exudative (serous) retinal detachment
- Subretinal fluid accumulates without a retinal break, typically secondary to inflammation, vascular disease or choroidal tumours.
Understanding the mechanism helps predict exam findings and the likely surgical approach.
Epidemiology and risk factors
RD is most common in middle‑aged and older adults but can occur at any age, especially after trauma. Risk factors include: