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Retinal Detachment

Ophthalmologic emergency in which the neurosensory retina separates from the underlying retinal pigment epithelium, causing acute photopsia, floaters, visual field defects ('curtain'), and progressive vision loss, requiring urgent surgical repair to preserve vision.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

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This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Göz Hastalıkları department. Book Appointment →

What is Retinal Detachment?

Retinal detachment (RD) occurs when the neurosensory retina separates from the underlying retinal pigment epithelium (RPE), classified into three main types: rhegmatogenous (RRD, 95% of cases, due to retinal tear/hole with vitreous liquefaction and PVD allowing fluid entry into subretinal space), tractional (TRD, due to fibrovascular membranes pulling retina, seen in proliferative diabetic retinopathy, sickle cell retinopathy, ROP), and exudative (subretinal fluid accumulation from inflammation, tumors, vascular disease without retinal break).

Rhegmatogenous RD pathogenesis involves age-related vitreous syneresis and posterior vitreous detachment (PVD) creating retinal tears (horseshoe tear, operculated hole, atrophic round hole), with vitreous fluid entering subretinal space and progressive detachment. Risk factors include high myopia (axial length >26mm), lattice degeneration, prior cataract surgery, ocular trauma, family history, prior RD in fellow eye, and pseudophakia.

Diagnosis requires urgent dilated fundus examination with scleral depression to identify retinal breaks, demonstrating elevated retina with corrugated appearance, often with shifting subretinal fluid. B-scan ultrasonography is useful when media opacity (vitreous hemorrhage) prevents visualization. OCT confirms macular involvement and guides surgical urgency: macula-on RD requires repair within 24-48 hours, while macula-off RD has more time but visual prognosis depends on duration of detachment (better outcome if <7 days).

Symptoms

Sudden flashes of light (photopsia)
Sudden shower of new floaters
Visual field defect ('curtain' or shadow)
Progressive peripheral to central vision loss
Distorted central vision (if macula involves)
Painless vision loss
Decreased visual acuity if macula-off

Risk Factors

High myopia (>-6 D or axial length >26 mm)
Posterior vitreous detachment (PVD)
Lattice degeneration with atrophic holes
Prior cataract surgery (pseudophakia)
Ocular trauma
Family history of retinal detachment
Prior retinal detachment in fellow eye

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Sudden new floaters or flashes (URGENT, same day)
  • Visual field defect or 'curtain' over vision (URGENT)
  • Sudden vision loss without pain (EMERGENCY)
  • Trauma with vision changes (urgent eye exam)
  • Postoperative vision changes after vitrectomy/buckle
  • High myopia patient with new symptoms
  • Shower of floaters in pseudophakic eye

Treatment Methods

01
Pars plana vitrectomy with gas/silicone oil tamponade (most common)
02
Scleral buckle (especially in young, phakic patients)
03
Pneumatic retinopexy (selected superior breaks, mobile patients)
04
Laser photocoagulation or cryopexy for retinal tears (preventive)
05
Postoperative face-down positioning (gas tamponade)
06
Avoidance of air travel during gas tamponade (intraocular gas expansion)
07
Long-term monitoring of fellow eye for prophylactic laser

Which Department to Visit?

You can visit our Göz Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Göz Hastalıkları Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.