Retinal Detachment

What's going on?

There is retinal tear, allowing fluid from the vitreous cavity to flow under the retina and peel it off. The vision goes down in this area and if the detachment progresses to lift off the macula, the central vision and thus visual acuity is markedly reduced. The retina needs to be stuck back down.

If I examine the patient, what will I find?

You may be able to see the raised, 'ruffled' appearance of the retina.

What if I've diagnosed it?

If you are confident you can see a retinal detachment, refer urgently.

If the patient is suffering from flashes and/or floaters refer them to their optician for assessment. If the patient has risk factors for retinal detachment such as a previous retinal detachment or tear, high myopia or has had previous cataract surgery they should be referred to the hospital.

What will the hospital do?

Treatment will involve either an internal repair by means of a vitrectomy with cryotherapy to seal the break in the retina or an external approach with a scleral buckling (indentation) procedure.

What to tell the patient

Visual prognosis is better if the macula remains attached. If the macula has been detached for a considerable period of time, the chance for visual recovery are minimal.

Problems that may arise, and how to deal with them

Such patients are at risk of a further detachment in the operated eye and in the other eye. Vigilance for symptoms of retinal detachment should be advised.