The retina is a layer of tissue at the back of the eye. Detachment is the separation from its normal position, usually due to a tear (although it can also occur due to traction or fluid accumulation).
It is more common in people over the age of 40, affecting more men than women and more whites than African Americans. Other risk factors include a family history of retinal detachment, myopia, eye trauma, previous cataract surgery and the use of medications such as fluoroquinolones.
Initial symptoms may include seeing dark or irregular "floaters" (myodesopsias), flashes of light (photopsias) and blurred vision. As it progresses, the patient often notices a "curtain", "veil" or shade of grey in the visual field. This deficit improves at night and worsens during the day (mainly with exertion). Sudden vision loss may also occur.
Diagnosis is based on ophthalmoscopy and ultrasound.
Urgent consultation with an ophthalmologist is necessary. Possible treatments include laser photocoagulation, cryoretinopexy, pneumatic retinopexy, scleral buckle or vitrectomy. Some asymptomatic patients or patients without high-risk features (visual field loss, decreased vision, vitreous haemorrhage or vitreous pigment on slit lamp examination) may not require initial treatment but should continue to be closely monitored.
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- Van Overdam KA, Bettink-Remeijer MW, Klaver CC, et al. Symptoms and findings predictive for the development of new retinal breaks. Arch Ophthalmol 2005; 123:479.
- Wolfensberger TJ, Tufail A. Systemic disorders associated with detachment of the neurosensory retina and retinal pigment epithelium. Curr Opin Ophthalmol 2000; 11:455.
- Wilkinson C. Interventions for asymptomatic retinal breaks and lattice degeneration for preventing retinal detachment. Cochrane Database Syst Rev 2001; :CD003170.
