Retinal detachment occurs when subretinal fluid accumulates in the potential space between the neurosensory retina and the underlying retinal pigment epithelium.
Symptoms
- Photopsias refer to the perception of flashing lights by the patient. It probably arises from the mechanical stimulation of vitreoretinal traction on the retina. It may be induced by eye movements and appears to be more noticeable in dim illumination.
- Visual field defect: Patients often describe a black curtain (visual field defect).
- Floaters
- Floaters are opacities in the vitreous that cast a dark shadow according to their form and shape in the patient’s visual field as they float in the vitreous cavity.
- A ring-shaped floater is the Weiss ring or the remnant of the hyaloid that was attached to the edges of the optic disc.
- Cobwebs are caused by condensation of the collagen fibers.
- Small spots usually indicate fresh blood due to the rupture of a retinal vessel during an acute PVD.
- Loss of central vision
- When the macula becomes detached (ie, extension of subretinal fluid into the macula), the patient experiences a drop in visual acuity.
- In other cases, a large bullous detachment may obstruct the macula, causing decreased visual acuity despite the fact that the macula is not detached.
The following are risk factors:
- Abnormal vitreoretinal adhesions
- Prior intraocular surgery, especially cataract extraction
- Certain familial conditions, such as Stickler syndrome, Marfan syndrome, homocystinuria, and Ehlers-Danlos syndrome
- Inflammatory or infectious conditions, such as acute retinal necrosis syndrome, CMV retinitis in AIDS patients, ocular toxoplasmosis, and pars planitis