Retinal detachment
- Lesion
Retinal detachment is the neural retina peeling off its pigment layer; without blood supply from below, photoreceptors die unless it is repaired fast.
What it is
The neural retina lies against the retinal pigment epithelium without a firm attachment; the space between them is a potential one. Detachment occurs when fluid enters this space through a retinal tear (rhegmatogenous), when scar tissue pulls the retina away (tractional) or when fluid leaks from vessels under an intact retina (exudative). Photoreceptors depend on the choroid and pigment epithelium, so detached retina degenerates within days and the macula determines the outcome.
Step by step
- With age the vitreous liquefies and separates from the retina.
- Where it is firmly attached, it pulls and tears the retina.
- Liquid vitreous passes through the tear into the subretinal space.
- The neural retina separates from the pigment epithelium and choroidal supply.
- Photoreceptor outer segments degenerate; if the macula detaches, central vision falls.
Types of retinal detachment
| Type | Mechanism | Typical setting |
|---|---|---|
| Rhegmatogenous | Liquid vitreous passes through a retinal break | Myopia, posterior vitreous detachment, after cataract surgery |
| Tractional | Contracting membranes pull the retina | Proliferative diabetic retinopathy, retinopathy of prematurity |
| Exudative | Fluid leaks under intact retina | Choroidal melanoma, malignant hypertension, inflammation |
Clinical notes
- New flashes and floaters call for a dilated retinal examination the same day or very soon.
- Surgery reattaches the retina; outcome is best if the macula is still attached.
Test yourself
Think of the answer, then tap the question to see it.
What is a rhegmatogenous retinal detachment?
A detachment caused by fluid from the vitreous passing through a retinal tear or hole into the subretinal space.
Which disease commonly causes tractional detachment?
Proliferative diabetic retinopathy, through contracting fibrovascular membranes.
Why do photoreceptors degenerate when the retina detaches?
They depend on the choroid and retinal pigment epithelium for oxygen, nutrients and renewal of outer segments.
Elsewhere in DurgiPedia
Connections
Educational content on the mechanisms of disease; not a diagnostic or treatment guide and no substitute for a health professional's advice. No doses are given.
Sources: Retinal Detachment | Retina | MedlinePlus (MedlinePlus, US National Library of Medicine, 2026).
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Representative model, for educational purposes only.