DEFINITION

Separation of
neurosensory retina
from the retinal
pigment epithelium by
sub retinal fluid.
Rhegmatogenous
caused by a
retinal break

Non-rhegmatogenous
Tractional
Exudative
a. Complete U-tear
b. Linear
c. Incomplete L-
shaped
d. Operculated
e. Dialysis
 Risk Factors for Retinal
Detachment
Common
Myopia
Focal retinal atrophy
Cataract surgery
Trauma
Less common
Diabetic retinopathy
Family History of detachment
Hereditary vitreoretinopathy
Uveitis
Predisposing peripheral degenerations
lattice degeneration

Present in
• 8% of general
population
• 40% of eyes with RD
• Overlying vitreous
liquefaction
• Exaggerated
attachments around
margin of lesion
 Complications of lattice
degeneration
• No complications - in
most cases
• RD associated with
atropic holes,
particularly in young
myopes
• RD associated with
tractional tears in
eyes with acute PVD
 Snailtrack degeneration

Sharply demarcated,
frost-like bands
which are longer than
lattice

Large round holes

which carry
high risk of RD
 White-without-pressure

Translucent grey
appearance of retina

Occasional giant tear

formation along
posterior margin of lesion
 Symptoms

• Photopsia

• Floaters

• Visual field defect

 Examination
• History
• Pupil reaction
• Slitlamp examination
Anterior segment
Biomicroscopy
Applanation
• Indirect
ophthalmoscopy
 Indirect ophthalmology
• Keep lens parallel to
patient’s iris plane.

• Avoid tendency to
move towards patient

• Ask the patient to

move eyes and head
into optimal positions
for examination
 Indirect ophthalmology

The higher the power,

the less the
magnification, the
shorter the working
distance but the
greater the field of
view
Scleral indentation
Break Localization
Break Localization
 Fresh RRD
• Convex, deep mobile
elevation
extending to ora
serrata
• Slightly opaque with
dark blood vessels
• Loss of choroidal
pattern
• Retinal breaks
 Longstanding RRD

• Frequently inferior
with small holes
• Very thin retina
• Secondary intraretinal
cysts
• Demarcation lines
(high-water marks)
Proliferative vitreoretinopathy

• Grade A (minimal)

Vitreous haze and

tobacco dust
Proliferative vitreoretinopathy
• Grade B (moderate)
Retinal wrinkling and
stiffness
Rolled edges of tears
Tortuous blood
vessels, vitreous
mobility
 Proliferative vitreoretinopathy
• Grade C (severe)
Rigid retinal folds
Vitreous condensations
and strands
Severity 1-12 clock hours
Type: 1 Focal
2 Diffuse
3 Subretinal
4 Circumferential
5 Ant Displacement
 Fundus drawing

Place chart upside

down

Draw what you see

Fundus drawing