Retinal Detachment

Separation of the retina from its underlying support layer

Overview

Retinal detachment is a separation of the neurosensory retina from the underlying retinal pigment epithelium and its blood supply. The most common type, rhegmatogenous detachment, begins with a tear or hole in the retina, often as the aging vitreous gel pulls away, which allows fluid to pass underneath. Other types are tractional, caused by scar tissue pulling on the retina as in diabetic eye disease, and exudative, caused by fluid accumulating without a break. Characteristic symptoms are sudden flashes of light, a shower of new floaters, and a shadow or curtain spreading across the visual field. Risk factors include high myopia, previous cataract surgery, eye trauma, lattice degeneration, and a family history. It is treated as an ophthalmic emergency, since visual outcomes are better when the macula has not yet detached. Retinal tears may be sealed with laser or cryotherapy, while detachments are repaired with pneumatic retinopexy, scleral buckling, or vitrectomy.