Snapshot A 65-year-old man presents to the emergency department for worsening vision loss. He reports that prior to developing these symptoms, he noted some floaters, along with bright lights. Ophthalmologic examination demonstrates a pale retina along with a retinal tear. Overview Separation of the retina from the retinal pigment epithelium 3 types primary retinal detachment (rhegmatogenous detachment) login to view 2 more bullets secondary retinal detachment login to view 3 more bullets recurrent retinal detachment login to view 1 more bullet Epidemiology Risk factors aging cataract surgery focal retinal atrophy myopia trauma diabetic retinopathy Marfan syndrome vitreous hemorrhage Pathophysiology Rhegmatogenous detachment entry of vitreous fluid into the subretinal space through a retinal break Exudative detachment entery of serous and/or hemorrhagic fluid into the subretinal space accomplished by systemic disease login to view 4 more bullets Tractional detachment mechanical forces on the retina proliferative diabetic retinopathy retinopathy of immaturity Presentation Symptoms increasing number of floaters photopsia bright flashes of light monocular visual loss dim "shadow" or "curtain" Physical retitina may appear pale tear may be seen Differential Migraine with aura differentiating factors patients typically have a throbbing headache dilated exam will show a normal retina Optic neuritis differentiating factors afferent pupilary defect ocular pain with movement optic nerve head edema Treatment Surgical pneumatic retinopexy indication login to view 1 more bullet scleral buckles indication login to view 1 more bullet pars plana vitrectomy indication login to view 1 more bullet Complications Permanent vision loss if not repaired Prognosis Vision typically salvaged if the detachment does not extend across the macula Great outcomes with treatment