Retinal Detachment

• Approximately 33–46% of patients with a retinal tear or hole will develop a retinal detachment
• Painless loss of vision
• Flashes and floaters may precede detachment 🡪
• painless visual field loss
  • as the photoreceptors become severely damaged by separation from their underlying choroidal vascular supply. 
  • superior retinal detachment 🡪 inferior visual field defect. 
  • ‘shadow’ or a ‘curtain coming down’ over their vision.
  • macula detachment = central visual acuity is lost and this is typically permanent

• Risks
  • Myopia
  • blunt/penetrating eye trauma
  • complicated cataract surgery
  • intraocular inflammation
  • previous retinal detachment
  • age > 50 years
  • family hx
• Type 2 diabetes can lead to proliferative diabetic retinopathy – > retinal bleeding – > vitreous hemorrhage – – mimics posterior vitreous detachment, and increases risk of retinal detachment
• Direct ophthalmoscopy alone is not enough as most retinal tears or detachment are in the peripher

Refer to ophthal to differentiate causes

• Semi urgent (within a week) – if vision is normal and without flashes
• Recent occasional flashes – semi urgent
• Recurrent and peristnent flashes- urgent within 24 hours
• If visual loss – then urgent within 24 hours