[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Ophthalmology](https://durgical.com/en/ophthalmology/) › [Ocular emergencies and trauma](https://durgical.com/en/ophthalmology/areas/emergencies/) › Retinal detachment: how fast to refer # Retinal detachment: how fast to refer - Emergency A retinal detachment is repaired by surgery. While central vision is still good it is an emergency, because saving the macula saves reading vision. Updated Nov 5, 2026 **See it in 3D:** [Retina](https://durgical.com/en/anatomy/retina/) · [Macula](https://durgical.com/en/anatomy/macula/) · [Vitreous](https://durgical.com/en/anatomy/vitreous-body/) · [Choroid](https://durgical.com/en/anatomy/choroid/) ## Key points - Curtain after floaters and flashes = retinal detachment. - Macula on = emergency (within about a day). - Rhegmatogenous (tear), tractional (diabetes), exudative (fluid). - Superior detachments threaten the macula faster. ## What it is In a retinal detachment the neural retina separates from the layer beneath it. The commonest type, rhegmatogenous, starts at a tear and lets fluid from the vitreous lift the retina. Tractional detachment comes from scar tissue pulling the retina (proliferative diabetic retinopathy); exudative detachment from fluid leaking under it (inflammation, tumours, severe hypertension or pre-eclampsia). The urgency depends on whether the macula is still attached. ## How to recognise it - Floaters and flashes followed by a shadow or curtain from the periphery. - Central vision still normal: the macula is on, and the case is an emergency. - Relative afferent pupillary defect if the detachment is large. - High myopia, previous cataract surgery, trauma or a detachment in the other eye. - Grey, folded retina on fundoscopy, or a membrane on ocular ultrasound. ## What to do at once - Measure visual acuity in each eye: good central acuity suggests the macula is still attached. - Map the shadow on the confrontation field: an upper shadow means a lower detachment and the reverse. - Look at the red reflex and try to see the retina; ocular ultrasound helps when the view is poor. - Telephone ophthalmology and arrange to be seen the same day. - Advise the patient to avoid strenuous activity and to travel without delay. ## Mistakes that cost sight - Superior detachments threaten the macula sooner, because fluid tracks downwards with gravity. - Once the macula has detached, final reading vision falls with each day of delay. - Treatments are a gas bubble (pneumatic retinopexy), a scleral buckle or a vitrectomy, chosen by the retina surgeon. ## Next step / Initial management - Macula on (good central vision): emergency referral for surgery within about 24 hours. - Macula off: urgent surgery within a few days. - Tractional or exudative detachment: ophthalmology the same day or within days, and treatment of the cause (diabetes, inflammation, blood pressure, tumour). - After repair, warn the patient about the symptoms in the other eye, which has a higher risk. ## Test yourself Think of the answer, then tap the question to see it. ## Why is a detachment with normal central vision more urgent than one with poor central vision? Because the macula is still attached: prompt surgery keeps reading vision, which is lost once the macula detaches. ## What are the three types of retinal detachment? Rhegmatogenous (from a tear), tractional (scar tissue pulling, as in diabetes) and exudative (fluid leaking under the retina). ## How can ocular ultrasound help? It shows a detached retina as a membrane in the vitreous cavity when blood or cataract block the view. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/ophthalmology/retinal-detachment-how-fast-to-refer/) ## Connections ## See it in 3D 4 The structures of Durgical's 3D anatomy where it is found. - [Retina](https://durgical.com/en/anatomy/retina/) - [Macula](https://durgical.com/en/anatomy/macula/) - [Vitreous](https://durgical.com/en/anatomy/vitreous-body/) - [Choroid](https://durgical.com/en/anatomy/choroid/) ## Related 4 - [Floaters and flashes](https://durgical.com/en/ophthalmology/floaters-and-flashes/) - [Sudden painless visual loss](https://durgical.com/en/ophthalmology/sudden-painless-visual-loss/) - [Ocular ultrasound and point-of-care scanning](https://durgical.com/en/ophthalmology/ocular-ultrasound-and-point-of-care-scanning/) - [Dilated fundus examination: when and how](https://durgical.com/en/ophthalmology/dilated-fundus-examination-when-and-how/) ## Related conditions 4 - [Retinal detachment](https://durgical.com/en/conditions/retinal-detachment/) - [Diabetic retinopathy](https://durgical.com/en/conditions/diabetic-retinopathy/) - [Refractive errors and presbyopia](https://durgical.com/en/conditions/refractive-errors-and-presbyopia/) - [Cataract](https://durgical.com/en/conditions/cataract/) [← All of ophthalmology](https://durgical.com/en/ophthalmology/) Educational content; not a clinical guideline and no substitute for assessment by a health professional. For sudden visual loss, severe eye pain, a chemical burn or an eye injury, go to an emergency department at once. Sources: [Retinal Detachment](https://www.ncbi.nlm.nih.gov/books/NBK551502/) (StatPearls Publishing (NCBI Bookshelf), 2024); [Exudative Retinal Detachment](https://www.ncbi.nlm.nih.gov/books/NBK589701/) (StatPearls Publishing (NCBI Bookshelf), 2024); [Point-of-Care Ocular Ultrasound](https://www.ncbi.nlm.nih.gov/books/NBK459120/) (StatPearls Publishing (NCBI Bookshelf), 2026). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/ophthalmology/retinal-detachment-how-fast-to-refer/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/ophthalmology/retinal-detachment-how-fast-to-refer/