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Retinal Detachment

Retinal detachment

Retinal folds
The billowy, gray spinnaker-like folds represent the detached retina—the part that has become elevated from its attachment to the underlying retinal pigment epithelium.

Retinal detachment
The usual cause is a break in the retina that allows vitreous fluid to seep underneath the retina and detach it.

In this schematic cross-section of the eye, the vitreous has detached itself from the retina. Common causes are aging, trauma, inflammation, high myopia, and intraocular surgery. In the anterior (peripheral) retina, where the vitreous is normally very adherent to the retina, this detachment has torn a hole in the retina. Liquid vitreous has seeped in through the hole and detached the retina. To see how retinal detachment usually develops, click here.

The patient would be blind in the visual field region corresponding to the detached area of retina.

What to do?
If the patient reports sudden flashes, floaters and field loss (the three Fs), refer emergently to an ophthalmologist. Retinal detachment requires emergency surgery to prevent its spread into the foveal region.

Paradoxically, referral is more emergent if visual acuity is normal than if it is abnormal, because the prognosis for good visual acuity is better if the fovea has not been detached at the time of retina reattachment surgery.

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