Retinal Detachment (RD)
Ocular Emergency: Clinical Essentials
1. Types of RD
| Type | Mechanism |
|---|---|
| Rhegmatogenous | A retinal break/tear allows vitreous fluid to enter the subretinal space. |
| Tractional | Vitreoretinal membranes pull the retina away (e.g., PDR). |
| Exudative (Serous) | Fluid accumulates under the retina without a tear (e.g., inflammatory/tumor). |
2. Clinical Features
- Symptoms: Photopsia (flashes of light), a sudden shower of floaters, and a curtain-like visual field defect.
- Signs: Elevated, wavy retinal appearance; shifting fluid (in exudative RD); loss of red reflex in severe detachment.
3. High-Yield Pearls
- Risk Factors: High myopia, lattice degeneration, previous cataract surgery, and ocular trauma.
- Macula-Off vs. Macula-On: Macula-on RD is a true ophthalmic emergency requiring surgery as soon as possible to preserve central vision.
- Shafer’s Sign: Presence of pigment cells (“tobacco dust”) in the anterior vitreous—highly suggestive of a retinal tear.