Eye Diseases > Retina
Retinal Detachment
Evidence-based assessment and management of retinal detachment. Comprehensive guide covering rhegmatogenous, tractional, and exudative subtypes, macular status, surgical decision-making, and emergency referral protocols for optometry practice.
Fundus view of a superior rhegmatogenous retinal detachment (RRD). The detached retina appears as a grey-white billowing elevation with visible retinal folds — contrasting with the normal orange-red attached retina inferiorly. A horseshoe tear at the superior margin is the break through which liquid vitreous has passed, progressively lifting the retina from the RPE. Subretinal fluid is encroaching on the macula. Tobacco dust (Shafer's sign) in the vitreous confirms the presence of a full-thickness break.
Retinal detachment (RD) is the separation of the neurosensory retina from the underlying retinal pigment epithelium (RPE). It is one of the most urgent ophthalmic emergencies — photoreceptors rapidly degenerate when deprived of the choroidal blood supply that normally diffuses through the intact RPE. Prompt diagnosis and surgical repair are critical to preserving vision.
Three pathophysiological types exist: rhegmatogenous (RRD — most common; caused by a full-thickness retinal break allowing liquid vitreous to enter the subretinal space), tractional (TRD — fibrovascular membranes pull the retina away without a break), and exudative (ERD — fluid accumulates beneath the retina from underlying choroidal disease without a break or traction).
Macular status at presentation is the single most important determinant of visual prognosis. Macula-on RRD requires same-day or next-day surgery to preserve central vision. Macula-off RRD should be repaired within 24 hours — longer delay significantly worsens visual recovery. Overall surgical anatomical success rates exceed 90% with modern techniques.
Most common type
Rhegmatogenous (RRD)
Key urgency factor
Macular status
Macula-on: surgery
Same day / 24 hrs
Anatomical success
>90% (modern PPV)
Rhegmatogenous Retinal Detachment (RRD)
Posterior vitreous detachment (PVD)
Most common precipitant of RRD. During PVD, dynamic vitreoretinal traction at sites of focal adhesion (lattice, tufts, vessels) creates full-thickness breaks through which liquid vitreous can pass.
Lattice degeneration
Present in ~8–10% of the population; responsible for ~30–40% of RRDs. Peripheral retinal thinning and vitreoretinal adhesion at lattice margins predispose to horseshoe tears and atrophic holes.
High myopia
Axial elongation thins the peripheral retina and increases lattice prevalence. Myopes have earlier PVD and significantly higher lifetime RRD risk.
Aphakia / pseudophakia
Post-cataract surgery eyes have a 1–3% RRD risk, further elevated by Nd:YAG capsulotomy. Altered vitreous dynamics accelerate PVD after lens removal.
Ocular trauma
Blunt contrecoup forces produce vitreoretinal traction at the vitreous base, causing dialyses. Penetrating trauma creates direct breaks. Both may present weeks to months after injury.
Tractional Retinal Detachment (TRD)
Proliferative diabetic retinopathy (PDR)
Most common cause of TRD globally. Fibrovascular membranes from PDR contract over the posterior pole, pulling the retina away from the RPE — particularly at the macula and along vascular arcades.
Retinopathy of prematurity (ROP)
Fibrovascular proliferation in the incompletely vascularised peripheral retina of preterm infants can progress to tractional and then rhegmatogenous detachment (Stage 4–5 ROP).
Sickle cell retinopathy
Sea-fan fibrovascular proliferation in the peripheral retina can cause combined tractional-rhegmatogenous RD.
Proliferative vitreoretinopathy (PVR)
Fibrocellular membranes forming after prior RRD or retinal surgery can cause secondary tractional re-detachment — the most common cause of surgical failure.
Exudative Retinal Detachment (ERD)
Choroidal tumours
Choroidal melanoma and metastases (from breast, lung, GI primaries) cause subretinal fluid accumulation through disrupted RPE and choroidal vasculature.
Vogt-Koyanagi-Harada (VKH) syndrome
Autoimmune posterior uveitis with bilateral serous exudative detachments, systemic features (meningism, vitiligo, alopecia), and rapid response to systemic corticosteroids.
Posterior scleritis
Inflammatory thickening of the sclera causes secondary choroidal and exudative retinal detachment; associated with pain behind the globe.
Eclampsia / severe pre-eclampsia
Choroidal vasospasm and ischaemia cause bilateral serous detachments; usually resolves with treatment of underlying hypertension and delivery.
Rhegmatogenous (RRD)
- 1PVD creates dynamic vitreoretinal traction at sites of focal adhesion → full-thickness retinal break forms (horseshoe tear, dialysis, or hole).
- 2Liquid vitreous passes through the break into the potential space between the photoreceptor outer segments and the RPE microvilli.
- 3The normal RPE pump (Na/K-ATPase-driven active transport) is overwhelmed by the rate of fluid ingress → subretinal fluid accumulates progressively.
- 4Neurosensory retina separates from RPE → photoreceptors are deprived of the choroidal blood supply that diffuses through the RPE → metabolic failure begins within hours.
- 5Outer segment disruption occurs rapidly. Central (foveal) photoreceptors are the most metabolically vulnerable — macular detachment causes rapid, potentially irreversible vision loss.
- 6Gravity determines the direction of fluid spread — superior breaks cause inferior progression; inferior breaks cause slow, gravity-dependent inferior detachment (classic for dialyses).
Tractional (TRD)
- 1Fibrovascular proliferative membranes (from PDR, ROP, penetrating trauma, or PVR) form on the retinal surface and within the vitreous.
- 2Membranes contract due to myofibroblast activity → tangential and/or anteroposterior traction pulls the retina toward the vitreous base.
- 3No retinal break is required — the retina is physically pulled away from the RPE by membrane contraction. The detachment is typically concave and relatively immobile.
- 4If traction is sufficient to create a retinal break, a combined tractional-rhegmatogenous RD results — more complex and urgent than either type alone.
Exudative (ERD)
- 1Disruption of the outer blood-retinal barrier (RPE and choriocapillaris) from tumour, inflammation, or vascular disease → protein-rich fluid leaks from the choroidal vasculature into the subretinal space.
- 2The retina is elevated by the accumulating fluid in a smooth, bullous, shifting configuration. Because there is no break, the fluid redistributes with changes in head position (shifting fluid sign — pathognomonic of exudative RD).
- 3No break or traction is present — the underlying cause must be identified and treated to resolve the detachment.
| Type | Mechanism | Break present? | Fluid behaviour |
|---|---|---|---|
| Rhegmatogenous (RRD) | Liquid vitreous through retinal break | Yes — full-thickness | Fixed; gravity-dependent spread from break |
| Tractional (TRD) | Fibrovascular membrane contraction | No (unless combined) | Concave, immobile, localised |
| Exudative (ERD) | Subretinal fluid from choroidal pathology | No | Smooth, bullous, shifting with position |
| Combined TRD-RRD | Traction creates a break → rhegmatogenous component added | Yes | Mixed — urgent surgical management |
By Macular Status (RRD — critical for urgency)
Macula-ON
Subretinal fluid has not reached the fovea. Central vision preserved. Requires same-day or next-day surgical repair to prevent macular involvement. Best visual prognosis.
Macula-OFF
Subretinal fluid beneath the fovea. Central vision lost. Surgery within 24 hours gives best VA recovery; delay beyond 1 week significantly worsens prognosis. Visual recovery is incomplete and variable.
By Extent
- Localised: <1 quadrant; subretinal fluid confined near break
- Subtotal: 1–3 quadrants; advancing subretinal fluid
- Total: All 4 quadrants; funnel-shaped detachment; insertion of retina at disc and ora serrata visible on B-scan
High myopia (>6D)
Axial elongation causes peripheral retinal thinning, lattice degeneration, and earlier PVD; risk is dose-dependent with increasing myopia
Posterior vitreous detachment
Most important acute precipitant; symptomatic PVD with flashes/floaters carries ~15% retinal break risk
Lattice degeneration
~8–10% population prevalence; accounts for ~30–40% of all RRDs; thinned retina at risk of breaks during PVD
Previous RRD or retinal tear
10–15% bilateral RRD risk; fellow eye requires thorough examination and prophylactic treatment of breaks
Aphakia / pseudophakia
1–3% RRD lifetime risk after cataract surgery; further elevated by YAG capsulotomy; altered vitreous dynamics
Family history of RRD
Increased risk, particularly in heritable vitreoretinal disorders (Stickler syndrome, Wagner syndrome, Marfan syndrome)
Ocular trauma
Blunt trauma causes dialyses; penetrating trauma causes direct breaks; dialyses may present late as slowly progressive inferior RRD
Proliferative diabetic retinopathy
Leading cause of TRD; fibrovascular proliferation and vitreoretinal contraction over the macula and arcades
Male sex
Higher overall RRD incidence; related to higher myopia rates and greater trauma exposure
Age 50–70 years
Peak incidence of symptomatic PVD in the sixth and seventh decades drives peak RRD incidence
Elevated, grey-white retina with folds
The detached neurosensory retina appears elevated, grey-white (loss of the normal red-orange choroidal reflex), and may show visible folds or billowing. The retinal vasculature appears tortuous as it traverses the elevated surface. Visible on fundus photography, wide-field imaging, and B-scan.
Shafer's sign (tobacco dust)
Pigmented RPE cells liberated through a retinal break into the anterior vitreous. Seen as brown granular particles in the superior vitreous on slit-lamp. Highly specific for full-thickness retinal break underlying the detachment. Absence does not exclude RRD.
Loss of red reflex
The elevated detached retina obscures the normal red choroidal reflex in the area of detachment. Visible on direct ophthalmoscope or when examining with the slit-lamp at low magnification.
Reduced intraocular pressure (hypotony)
The detached RPE loses its contribution to aqueous outflow and fluid absorption, causing a relative reduction in IOP. IOP in the detached eye is typically 2–5 mmHg lower than the fellow eye. Useful confirmatory sign when fundal view is poor.
Relative afferent pupillary defect (RAPD)
Present in extensive macula-off detachments when sufficient photoreceptor function is lost. An RAPD in a patient presenting with sudden visual loss and absent red reflex is an ophthalmic emergency.
Shifting subretinal fluid (exudative RD)
Characteristic of exudative RD — the smooth, bullous detachment changes position with head posture (e.g., supine vs upright). Pathognomonic for the exudative type; distinguishes it from RRD and TRD.
Retinal break at the leading edge
In RRD, the causative break is typically at the highest point of the detachment — superior for superior breaks, nasal or temporal for their respective quadrants. The flap of a horseshoe tear may be visible at the border of the detachment.
B-scan ultrasound findings
Highly reflective, mobile membrane attached at the optic disc and ora serrata (RRD); concave, immobile membrane (TRD); smooth choroidal elevation without subretinal membrane (exudative). Essential when media opacity prevents direct fundal view.
Peripheral shadow or curtain
The most important and specific symptom of RRD. A dark shadow or curtain advancing from one side of the visual field — typically from the side opposite the break (e.g., superior break → inferior curtain). Indicates accumulating subretinal fluid. Warrants same-day emergency referral.
Sudden floaters
New onset shower of floaters, cobwebs, or a ring — from liberated vitreous pigment, red blood cells (vessel tear), or the Weiss ring from PVD. Floaters precede the detachment in most RRDs — the warning phase.
Photopsia (flashes)
Monocular, peripheral, typically temporal flashes of light from vitreoretinal traction stimulating photoreceptors. Often accompanies or precedes the detachment. Combined flashes and floaters demand urgent examination.
Sudden central visual loss
Occurs when subretinal fluid reaches the macula (macula-off RRD). The patient may describe a sudden drop in vision, blurring, or complete loss of central vision. Absence of pain is characteristic — distinguishes from acute angle closure glaucoma.
Distortion or field defect
Metamorphopsia when fluid approaches the macula. A scotoma or sector field loss corresponding to the area of detachment — inferior detachment causes superior field loss.
Asymptomatic (inferior / dialysis detachments)
Slowly progressive inferior detachments — particularly traumatic dialyses — may be asymptomatic for weeks to months, discovered incidentally. Patients may not notice a superior field defect (which is often perceived as less threatening). This underscores the importance of routine fundus examination in at-risk patients.
Permanent central visual loss
The most feared outcome. Even after successful anatomical reattachment, macula-off RRDs — particularly those of long duration — result in incomplete visual recovery due to photoreceptor degeneration. Metamorphopsia is often persistent.
Proliferative vitreoretinopathy (PVR)
The most common cause of surgical failure (~10% of RRD repairs). RPE cells and glial cells proliferate on both surfaces of the retina after break formation; fibrocellular membranes contract and re-detach the retina. PVR requires complex re-operation, often with silicone oil.
Choroidal detachment
Separation of the choroid from the sclera secondary to low IOP (hypotony) following RRD. The choroidal detachment fluid appears as smooth, dark, peripheral elevations on fundoscopy. Usually resolves with RRD repair; may require drainage if severe.
Rubeosis iridis and neovascular glaucoma
Chronic, longstanding RRD causes retinal ischaemia and VEGF release → neovascularisation of the iris (rubeosis) and drainage angle → secondary neovascular glaucoma. A late complication of neglected detachment.
Phthisis bulbi
End-stage consequence of untreated or failed RRD. Progressive loss of IOP, ocular atrophy, and calcification. Irreversible; severely cosmetically and functionally compromised globe.
Post-operative refractive change
Scleral buckling adds axial length and induces myopia (typically 2–3D). High myopes are particularly affected. Gas tamponade after PPV causes temporary hyperopia and near-vision disturbance during the fill period.
Cataract formation
Accelerated by PPV (vitreous removal alters lens metabolism) and prolonged silicone oil tamponade. Most PPV eyes develop cataract within 2–5 years; often managed with combined or subsequent phacoemulsification.
Diabetes mellitus (PDR)
Proliferative diabetic retinopathy is the leading cause of tractional RD globally. Fibrovascular proliferative membranes along the posterior vitreous face contract after PVD, pulling the macula and posterior retina away from the RPE. Pre-operative intravitreal anti-VEGF reduces intraoperative bleeding. Tight glycaemic control and PRP reduce TRD risk.
Stickler syndrome (COL2A1, COL11A1)
Autosomal dominant connective tissue disorder; most important heritable cause of giant retinal tears and juvenile RRD. Abnormal vitreous (membranous or beaded), high myopia, deafness, and mid-face hypoplasia. All first-degree relatives require retinal surveillance; prophylactic 360° laser may be considered.
Marfan syndrome (FBN1)
Ectopia lentis, high myopia, and altered vitreoretinal adhesion increase RRD risk. Aortic root aneurysm is the primary systemic concern; cardiovascular and ophthalmic co-management is essential.
Vogt-Koyanagi-Harada (VKH) syndrome
Bilateral granulomatous panuveitis with exudative RD, meningism, tinnitus, vitiligo, poliosis, and alopecia. Autoimmune T-cell attack on melanocytes. Bilateral bullous exudative RDs respond rapidly to high-dose systemic corticosteroids. Recurrence causes progressive chorioretinal atrophy (sunset glow fundus).
Eclampsia / severe pre-eclampsia
Choroidal vasospasm from severe hypertension causes bilateral exudative RDs, typically serous and bullous. Usually self-limiting following delivery and blood pressure control. Ophthalmology involvement is part of the multidisciplinary management of severe pre-eclampsia.
Choroidal malignancy and metastases
Uveal melanoma is the most common primary intraocular malignancy in adults and can cause exudative RD. Choroidal metastases (breast, lung most common) present with bilateral exudative detachments. Urgent oncology and ophthalmology referral required.
Sickle cell disease (HbSS / HbSC)
Peripheral sea-fan neovascularisation (proliferative sickle retinopathy) can cause combined tractional-rhegmatogenous RD. HbSC disease paradoxically has higher retinal risk than HbSS due to increased blood viscosity.
Retinopathy of prematurity (ROP)
Fibrovascular proliferation at the avascular-vascular retinal border in preterm infants can cause TRD (Stage 4 ROP — partial detachment) and total RRD (Stage 5). Urgent intervention (laser, anti-VEGF, vitreoretinal surgery) is required in severe ROP.
Fundus camera / wide-field imaging (Optos)
Within optometry scope. Non-mydriatic or wide-field fundus photography documents the extent and location of detachment, identifies retinal folds, and confirms the presence of subretinal fluid. Wide-field imaging (200°) captures most peripheral detachments. Critical for triage, documentation, and referral communication.
B-scan ultrasound
Gold standard when media opacity (vitreous haemorrhage, dense cataract) prevents fundal view. RRD: highly reflective, mobile membrane with insertions at disc and ora serrata. TRD: concave, immobile, tethered by fibrovascular membranes. Exudative: smooth choroidal elevation, shifting fluid, no membrane. Essential for any eye with suspected RD and poor fundal view.
OCT (posterior pole)
Confirms macular status — subretinal fluid beneath the fovea (macula-off) vs intact foveal attachment (macula-on). Critical for surgical planning and urgency triage. Also identifies pre-existing ERM, cystoid oedema, and outer retinal disruption. Cannot visualise peripheral detachment.
Intraocular pressure (IOP) measurement
Hypotony (IOP 2–5 mmHg lower than fellow eye) supports the diagnosis of RRD — the detached RPE loses its pumping function. Normal or elevated IOP does not exclude detachment but makes it less likely in the absence of other features.
Visual acuity
Baseline essential. Normal VA may be present in macula-on detachments or peripheral-only disease. Sudden VA reduction indicates macular involvement. Documents urgency and guides surgical planning.
Visual field assessment
A relative or absolute scotoma corresponding to the area of detachment (inferior field loss for superior detachment) can be detected on confrontation or formal visual field testing. Particularly useful for patients with subtle, slowly progressive inferior detachments.
Binocular indirect ophthalmoscopy + scleral indentation
Ophthalmology scope only. The definitive examination for identifying the retinal break, mapping the full extent of detachment, and confirming the location and type of all breaks. Scleral indentation is mandatory to examine the peripheral retina anterior to the equator. Not within Singapore optometry practice — refer urgently.
1. Rhegmatogenous RD — Surgical Emergency
Pneumatic retinopexy
Office-based procedure suitable for superior breaks, phakic eyes, and single or small cluster of breaks within one clock hour. An expansile gas bubble (C3F8 14% or SF6 25%) is injected intravitreally; patient positioned to float the bubble against the break; laser or cryo seals the break. Primary success ~70–80% for appropriate cases; avoids general anaesthesia.
Scleral buckle
A silicone band or sponge is sutured externally around or segmentally over the globe, indenting the sclera to reduce vitreoretinal traction and bring the RPE toward the break. Preferred for young phakic patients, inferior breaks, dialyses, and cases with strong vitreoretinal adhesion. Primary success ~85–90%; induces ~2–3D myopic shift.
Pars plana vitrectomy (PPV)
The most widely used modern technique. Vitreous removal eliminates dynamic traction; the retina is reattached using perfluorocarbon liquid (PFCL) or fluid-air exchange; the break is sealed with endolaser retinopexy; gas (SF6, C3F8) or silicone oil tamponade holds the retina while adhesion forms. Primary success ~85–95%. Face-down positioning required for posterior breaks during the tamponade period.
Combined scleral buckle + PPV
For complex cases with multiple breaks, PVR, or giant retinal tears. The buckle supports the vitreous base while PPV addresses the posterior retina and any subretinal PFCL. Silicone oil tamponade used when long-term support is needed (PVR, inferior breaks, poor compliance with positioning).
2. Tractional RD
PPV with membrane peeling
Fibrovascular membranes are segmented and delaminated from the retinal surface using vitreoretinal scissors and forceps. Silicone oil tamponade is typically used due to the complexity of these cases and the risk of PVR. Pre-operative intravitreal anti-VEGF (bevacizumab) 1–2 weeks before surgery reduces intraoperative bleeding and facilitates membrane dissection.
Treat underlying cause
PDR: Panretinal photocoagulation and anti-VEGF to reduce neovascularisation before and after surgery. ROP: Laser ablation of avascular retina or intravitreal anti-VEGF (bevacizumab) for aggressive posterior ROP; vitreoretinal surgery for Stage 4–5.
3. Exudative RD
Treat the underlying cause
No retinal surgery is required for pure exudative detachment. VKH: high-dose systemic corticosteroids resolve the detachment rapidly. Choroidal melanoma: plaque radiotherapy or enucleation. Choroidal metastases: systemic oncology management + intravitreal anti-VEGF or external beam radiotherapy. Posterior scleritis: systemic NSAIDs or corticosteroids. Eclampsia: antihypertensives and delivery.
Singapore Optometry Scope Note
Optometrists in Singapore use non-mydriatic fundus cameras, wide-field imaging, and OCT to assess retinal health — dilated fundus examination and binocular indirect ophthalmoscopy are not within optometry scope of practice. Any patient reporting a peripheral shadow, curtain, sudden onset floaters, or reduced vision must be treated as a same-day ophthalmic emergency and referred immediately to ophthalmology. OCT can help confirm macular status (on vs off) before referral. Do not delay referral to perform additional investigations — macular-on RRD requires surgical repair within hours to preserve central vision. All surgery (PPV, scleral buckle, pneumatic retinopexy) is performed by ophthalmologists.
RRD — macula-on (treated within 24 hours)
Excellent. Anatomical success >90% with modern PPV. VA returns to near pre-detachment levels in most patients (>6/12 in ~90%). Persistent metamorphopsia is common even with successful reattachment due to photoreceptor displacement.
RRD — macula-off (<1 week duration)
Good anatomical success (~90%); VA 6/12 or better in ~50–60% of operated eyes. Recovery improves with shorter macular detachment duration — each day of delay worsens prognosis.
RRD — macula-off (>1 week duration)
Reduced VA recovery despite successful anatomical reattachment. Fewer than 50% achieve 6/12. Outer photoreceptor degeneration is progressive and largely irreversible beyond 1 week of macular detachment.
Re-detachment and PVR
~10% of primary PPV repairs develop PVR re-detachment requiring re-operation. Final anatomical success after re-operation is ~85–90%, but functional outcomes are significantly worse than primary repairs.
Tractional RD (PDR)
Variable — depends on pre-operative macular involvement and duration of traction. Macula-on TRD: ~70–80% achieve good VA after PPV + membrane peeling. Macula-off TRD: recovery is less complete; persistent macular traction may cause long-term metamorphopsia.
Exudative RD
Depends entirely on successful treatment of the underlying cause. VKH responds rapidly to corticosteroids with near-complete resolution of detachment and good VA recovery. Choroidal metastases carry a poor systemic prognosis but local treatment can preserve useful vision.
Fellow eye
10–15% bilateral RRD incidence. The fellow eye must be examined and all at-risk lesions (horseshoe tears, symptomatic holes, lattice with holes) treated prophylactically. Annual surveillance of high-risk fellow eyes is recommended.
| Condition | Key Differentiator |
|---|---|
| Retinoschisis | Splitting of retinal layers (not subretinal fluid); smooth, dome-shaped, immobile elevation; usually inferotemporal; thin inner leaf; no Shafer's sign; rarely progresses; B-scan and OCT confirm — low reflectivity inner layer, intact photoreceptors on OCT |
| Choroidal detachment | Dark, smooth, peripheral elevation behind the ora serrata; low IOP and post-surgical/post-traumatic context; does not cross the disc or ora; B-scan shows choroidal (not retinal) elevation; kissing choroidals in severe cases |
| Retinal tear (without detachment) | Full-thickness break without accumulation of subretinal fluid beyond the break margin; no billowing elevation; Shafer's sign may be present; precedes RRD — treat immediately to prevent detachment |
| Choroidal melanoma | Solid pigmented choroidal mass elevating the overlying retina; smooth, dome-shaped or mushroom-shaped; B-scan shows solid mass with internal echoes (not fluid); urgent ocular oncology referral required |
| Choroidal haemangioma | Vascular choroidal tumour; orange-red on fundoscopy; bright on B-scan (high internal reflectivity); may cause exudative RD; no traction or break; responds to PDT |
| Central serous chorioretinopathy (CSCR) | Serous neurosensory detachment limited to the posterior pole; RPE leak on FFA; young to middle-aged men; self-limiting; no peripheral break; OCT shows subretinal fluid without retinal break or fold |
| Vogt-Koyanagi-Harada (VKH) | Bilateral bullous exudative RD + anterior uveitis + systemic features (meningism, tinnitus, vitiligo, alopecia); shifting fluid; no break; responds rapidly to systemic corticosteroids; bilateral presentation is the key differentiator from RRD |
| Posterior scleritis | Exudative RD + choroidal folds + T-sign on B-scan (fluid in Tenon's space behind the globe); associated with ocular pain; FFA shows pinpoint leaks; systemic NSAIDs or corticosteroids effective |
- Heimann H, Bartz-Schmidt KU, Bornfeld N, Weiss C, Hilgers RD, Foerster MH. Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment: a prospective randomized multicenter clinical study. Ophthalmology. 2007;114(12):2142-2154.
- Mitry D, Charteris DG, Fleck BW, Campbell H, Singh J. The epidemiology of rhegmatogenous retinal detachment: geographical variation and clinical associations. Br J Ophthalmol. 2010;94(6):678-684.
- Wilkinson CP, Rice TA. Michels Retinal Detachment. 2nd ed. St Louis: Mosby; 1997.
- Adelman RA, Parnes AJ, Ducournau D. Strategy for the management of uncomplicated retinal detachments: the European vitreo-retinal society retinal detachment study report 1. Ophthalmology. 2011;118(5):971-977.
- Ross W, Lavina A, Russell M, Maberley D. The correlation between presence of a demarcation line and good visual acuity in macula-off retinal detachments. Ophthalmology. 2005;112(6):1192-1198.
- Schwartz SG, Flynn HW Jr, Lee WH, Wang X. Tamponade in surgery for retinal detachment associated with proliferative vitreoretinopathy. Cochrane Database Syst Rev. 2014;(2):CD006126.
- Byer NE. Natural history of posterior vitreous detachment with early management as the premier line of defense against retinal detachment. Ophthalmology. 1994;101(9):1503-1514.
- Feltgen N, Walter P. Rhegmatogenous retinal detachment — an ophthalmologic emergency. Dtsch Arztebl Int. 2014;111(1-2):12-22.
- Lois N, Wong D. Pseudophakic retinal detachment. Surv Ophthalmol. 2003;48(5):467-487.
- Kang HK, Luff AJ. Management of retinal detachment: a guide for non-ophthalmologists. BMJ. 2008;336(7655):1235-1240.
- Yorston D, Jalil A. Preventing blindness from retinal detachment. Community Eye Health. 2012;25(79-80):44-46.
- Aylward GW, Sullivan TJ, Elston JS. The clinical and electrophysiological characteristics of stargardt disease and cone dystrophy. Eye (Lond). 1993;7(Pt 2):195-200.
- Brazitikos PD, Androudi S, Christen WG, Stangos NT. Primary pars plana vitrectomy versus scleral buckle surgery for the treatment of pseudophakic retinal detachment. Retina. 2005;25(8):957-964.
- American Academy of Ophthalmology. Preferred Practice Pattern: Retinal Detachment and Predisposing Lesions. San Francisco: AAO; 2019.
- Pierro L, Camesasca FI, Mischi M, Brancato R. Peripheral retinal changes and axial myopia. Retina. 1992;12(1):12-17.