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Sean Pak,
Brad H. Feldman, M.D.,
Paul Phelps, MD, FACS,
Aaron M. Miller, MD, MBA, FAAP,
Alexander Barash, MD,
Anna Murchison, MD, MPH,
Grant A. Justin, MD,
Jonathan C. Tsui, MD,
Neelakshi Bhagat, MD, FACS,
Jennifer I Lim MD,
Kevin E Lai, MD,
Sayjal J. Patel M.D.,
Peter A.Karth, MD,
Vamsi Gullapalli, MBBS, PhD,
Matthew Starr, MD,
Grant C. Hilliard,
Abdulaziz Khoshaim M.D
Assigned status Up to Date
by
Matthew Starr, MD on April 30, 2026.
Disease
Retinal detachment is a sight-threatening condition with an incidence of approximately 1 in 10000, with higher rates observed in males, myopic eyes, or after ocular surgery (i.e. cataract surgery).[1][2] It occurs when subretinal fluid accumulates between the neurosensory retina and the retinal pigment epithelium, resulting in disruption of photoreceptor function and consequential vision loss. Prior to the 1920s, it was a permanently blinding condition. In subsequent years, Jules Gonin, MD, pioneered the first retinal detachment repairs in Lausanne, Switzerland.[3] In 1945, after the development of the binocular indirect ophthalmoscope by Charles Schepens, MD, techniques for retinal detachment repair improved. In the last 50 years, techniques in scleral buckling, pneumatic retinopexy, vitrectomy, and panretinal photocoagulation (PRP) have made the repair of retinal detachments significantly more manageable with better visual outcomes.
Types of Retinal Detachment
- Rhegmatogenous Retinal Detachment
- Traction Retinal Detachment
- Exudative (Serous) Retinal Detachment
- Combined Detachment
Illustration of Types of Retinal Detachment by Sean Pak.
Key Risk Factors for Retinal Detachment
| Rhegmatogenous
|
Tractional
|
Exudative (Serous)
|
- Lattice degeneration (considered most important)
- High myopia (especially >-6 diopters or axial length >26 mm)
- Advancing age (risk increases with age, but myopic RRD occurs at younger ages)
- Male sex
- Previous cataract surgery (pseudophakia/aphakia)
- Ocular trauma
- Family history of retinal detachment
- History of retinal detachment or tear in the fellow eye
|
- Proliferative diabetic retinopathy (most common cause)
- Retinal vein occlusion
- Sickle cell retinopathy
- Retinopathy of prematurity
- Ocular trauma (causing proliferative vitreoretinopathy)
- Extensive retinal neovascularization and large areas of non-perfusion in diabetic retinopathy
|
- Ocular inflammatory diseases (e.g., Vogt-Koyanagi-Harada syndrome, sympathetic ophthalmia, panuveitis, posterior scleritis)
- Choroidal tumors (e.g., melanoma, metastases)
- Vascular abnormalities (e.g., central serous chorioretinopathy, hypertensive choroidopathy)
- Systemic diseases (e.g., preeclampsia, malignant hypertension)
- Infectious and infiltrative diseases (e.g., tuberculosis, leukemia)
|
Pathophysiology
