Retinal detachment

History:

  • A recent history of floaters and flashes of light are common
  • Curtain coming across the vision 
Examination:
  • Visual acuity variable depending if the macula is involved. If the vision is normal,

  • referral becomes more urgent as the macular function may be involved by the extension 
    of the detachment.
  • Visual field defect 
  • Ophthalmic examination in a dilated pupil shows greyish retina, hole and tear may be seen. 
Management:
  • Refer the patient the same day 
  • Patients will require surgical management which consists of sealing the retinal breaks 

  • (using cryotherapy or laser) and relieving the vitreous traction (using indentation or vitrectomy)
Figure 1
This patient presented to the eye casualty with a sudden onset black shadow over his right 
eye.Fundoscopy reveals a retinal detachment. Note the wrinkled retina; this is a common 
sign of retinal detachment.
Figure 2
A patient with retinal detachment showing retinal tear.This patient requires treatment to seal
the hole in order to prevent retinal detachment. This can either be achieved with laser or 
cryotherapy. In patients who complain of sudden onset floaters, it can be difficult 
to find abnormalities with a direct ophthalmoscope as the tears or holes are often in 
the peripheral retina. Therefore, it is important to refer all patients with sudden onset floaters.

Return to sudden visual loss