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Neurology · Additional Topics

Retinal detachment

*Descolatio retinae*

Retinal detachment is a dangerous ophthalmological condition in which the light-sensitive membrane of the eye separates from the underlying tissues. The pathology is accompanied by a sharp deterioration in vision, the appearance of flashes, and a "curtain" before the eye.

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Main complaintsFlashes, photopsias, and the "curtain" effect before the eye
Main causeRetinal tear and the penetration of fluid from the vitreous body
TreatmentConservative therapy is not performed; only laser and surgical treatment
Surgical methodsEpiscleral surgery and intravitreal interventions
3 min readFor medical studentsUpdated 10.10.2026
Material prepared by WhiteCoat Pro editorial team based on platform study guidesPending instructor review

Causes and etiology

There are three main types of retinal detachment depending on the development mechanism:

  • Dystrophic (primary, idiopathic, rhegmatogenous): develops due to a retinal tear through which fluid from the vitreous body seeps inside.
  • Traumatic: occurs due to direct eye trauma, contusion, or a penetrating wound.
  • Secondary: is a consequence of other eye diseases—uveitis, retinitis, choroidal tumors, vascular disorders, hemorrhages, retinopathies (diabetic, renal), and central retinal vein occlusion (CRVO).

Risk factors include a burdened family history, myopia, prior injuries, and physical strain.

Clinical presentation and symptoms

Patients with retinal detachment present with characteristic subjective complaints:

  1. Flashes of light and photopsias.
  2. The appearance of a dark or translucent "curtain" narrowing the visual field.
  3. Sudden decrease in visual acuity.
  4. Floaters (occur with partial hemophthalmos if the tear affects a retinal vessel).

During ophthalmoscopy, the red reflex of the fundus disappears in the affected area, the retina acquires a grayish-whitish tint, and its vessels appear darker and more tortuous. Depending on the height, flat, high (bullous) detachments are distinguished, and with long-standing pathology, rough folds and a fixed funnel shape are formed.

Test your knowledge on this topicTasks from the Neurology course bank — immediate answers and explanations.

Diagnostics and characteristics of tears

A comprehensive examination is used to establish an accurate diagnosis:

  • Visometry and tonometry.
  • Perimetry (with sufficient visual acuity).
  • Biomicroscopy and biomicroscopy with a Goldmann three-mirror lens for a detailed examination of the optic disc (OD) and retina.
  • Indirect binocular ophthalmoscopy and biomicroscopy with high diopter lenses.
  • Ultrasound examination (ultrasound)—indicated for opacities of the ocular media or to rule out choroidal neoplasms.

Upon examination, retinal tears appear red. They vary in shape (hole-like, flap-like, operculated, atypical), number (single or multiple), and localization (central, paracentral, equatorial, and ora serrata region).

Treatment: laser and surgery

Conservative therapy for retinal detachment is not performed.

  • Laser treatment: Indicated for local detachments to perform barrier laser photocoagulation. Important rule: if the detachment extends beyond the coagulates, the procedure is not repeated, and the patient is referred for surgery.
  • Surgical treatment: The goals are to seal the tears and eliminate vitreoretinal tractions.
  • Episcleral surgery: local or circular buckling using silicone bands to approximate the membranes.
  • Intravitreal interventions: include vitrectomy (excising the vitreous body), cavity tamponade (air, gases, PFO, silicone oil), and endolaser photocoagulation.
How to memorize

Tears are red, the retina is grayish, and a curtain before the eye is a signal to run for an examination immediately.

Class and exam questions

Which symptoms first indicate a retinal detachment?

Patients notice flashes of light (photopsias), floaters, a sharp decrease in visual acuity, and an encroaching "curtain" from some side of the visual field.

Can retinal detachment be cured using only drops and pills?

No, conservative therapy is not used for this condition. Only laser methods (for local tears) or surgical intervention are employed.

In which cases is an eye ultrasound mandatory?

Ultrasound is performed when the refractive media of the eye are opaque (to assess detachment parameters), as well as to rule out a space-occupying choroidal lesion.

What are the main goals of surgical treatment for retinal detachment?

The main objectives of the surgery are to securely seal retinal tears and eliminate vitreoretinal adhesions (tractions) that pull the retina into the vitreous cavity.

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Prepared by WhiteCoat Pro faculty in accordance with the medical school curriculum. For educational purposes only.