Clinical meaning
Retinal detachment occurs when the neurosensory retina separates from the underlying retinal pigment epithelium (RPE), disrupting the retinal blood supply and causing progressive vision loss. Three types: Rhegmatogenous (most common) — a break or tear in the retina allows vitreous fluid to seep between the neurosensory retina and RPE, separating them. Often preceded by posterior vitreous detachment (PVD) where the vitreous gel shrinks and pulls away from the retina with aging, sometimes creating a tear. Tractional — fibrovascular membranes (from diabetic retinopathy, retinopathy of prematurity) physically pull the retina away from the RPE. Exudative — fluid accumulates beneath the retina from inflammatory conditions, tumors, or vascular abnormalities (no tear present). Key symptoms: sudden onset of flashes of light (photopsia — from retinal traction), new floaters (pigmented cells released into vitreous), and a curtain or shadow progressing across the visual field. This is an OPHTHALMOLOGIC EMERGENCY — permanent vision loss occurs if the macula detaches. Central vision is preserved only if the macula remains attached.