Retinal detachment
In retinal detachment, separation of the retinal layers creates a subretinal space that fills with fluid. Twice as common in males as in females, retinal detachment may be primary or secondary. The disorder usually involves only one eye but may occur in the other eye later. Rarely healing spontaneously, a detached retina can usually be reattached successfully with surgery. The prognosis depends on the area of the retina affected.
Causes
A retinal detachment may be primary or secondary. A primary detachment occurs spontaneously because of a change in the retina or the vitreous, whereas a secondary detachment results from another problem, such as intraocular inflammation or trauma. The most common cause of retinal detachment is a hole or tear in the retina. This hole allows the liquid vitreous to seep between the retinal layers and separate the sensory retinal layer from its choroidal blood supply. In adults, retinal detachment usually results from degenerative changes related to aging (which cause a spontaneous tear). Predisposing factors include myopia, cataract surgery, and trauma.
Additionally, retinal detachment may result from fluid seeping into the subretinal space as an effect of inflammation, tumors, or systemic disease. Detachment may also result from traction placed on the retina by vitreous bands or membranes (resulting from proliferative diabetic retinopathy, posterior uveitis, or a traumatic intraocular foreign body, for example).
Retinal detachment can also be inherited, usually in association with myopia.
Pediatric pointerRetinal detachment may occasionally develop ina child from retinopathy of prematurity, tumors (retinoblastomas), or trauma.
Complications
Retinal detachment may result in severe vision impairment and possible blindness. The patient with spontaneous retinal detachment has a 20% to 25% risk of future retinal detachment in the other eye.
