Retinal detachment (RD) is the separation of the sensory retina from retinal pigment epithelium. It may be localized or entire retina may be involved. Retinal detachment that includes the macula results in significant visual loss. The three types are Rhegmatogenous RD, exudative RD and tractional RD.

Clinical features:

Ø  Rhegmatogenous RD is characterized by formation of a tear in the retina.

Ø  Symptoms include flashes of light, presence of floaters in visual field and loss of central vision, if macula is involved.

The diagnosis is done by examination of the fundus with indirect ophthalmoscopy. The retina appears grey wit oscillating folds.

l  Tractional RD is caused by gliotic bands on retina.

l  Exudative RD is caused by collection of serous fluid between neurosensory retina and retinal pigment epithelium.

Non- pharmacological treatment:

l  Treatment of choice is reattachment surgery involving identification of all retinal breaks areas of vitreous or retinal tractions and induction of aspectic chorioretinal inflammation around the breaks to seal them.

l  Ensuring chorioretinal apposition by approximating choroid/retinal pigment epithelium to neurosensory retina by external tamponade, internal tamponade and drainage of subretinal fluid

l  Adhesion between retinal pigment epithelium and retina can be achieved by cryotherapy, diathermy or photocoagulation.

Pharmacological treatment:

1.       No pharmacological treatment which can prevent or cure rhegmatogenous RD.

2.       Exudative RD due to inflammatory conditions like panuveitis can be treated with systemic corticosteroids as described in treatment of uveitis. The refractory patients can be treated with immunosuppresants.

Patient education:

u  Patients with high myopia, family history of RD, post cataract surgery, past episodes of chorioretinal inflammation should be warned about the premonitory signs of impending RD (sudden onset of floaters, flashes of light and sudden obscuration of one part of visual field). In such cases, an opthalmologist should be contacted immediately.