Rhegmatogenous retinal detachment is the most
common type of detachment. It is caused by holes or breaks in the retina called
retinal tears. A retinal tear allows fluid from the middle of the eye to pass
through the tear and settle under the retina. As the fluid builds up under the
retina, it pushes the retina away from the layer beneath it.
The most frequent cause of retinal tears is posterior vitreous
detachment (PVD). PVD is a normal part of aging, in which the
vitreous gel separates from the retina. PVD is usually harmless, but sometimes the vitreous gel can
pull so hard that it tears the retina. Retinal tears occur most often on the
sides (periphery) of the retina, because the vitreous gel is attached to the
retina most strongly in those areas. If eye fluid moves through the tear and builds up under the retina, the retina may come off the back of the eye.
Retinal tears often do not lead to retinal detachment. But
retinal tears that occur with new symptoms (such as
flashes of light, or other visual disturbances) are
much more likely to progress to detachments. A retinal detachment also may be
more likely to occur if you have other things that increase your risk—for example, if you are nearsighted or if you have had recent cataract surgery.
Traction retinal detachment occurs when scar
tissue or other abnormal tissue grows on the surface of the retina, pulling the
retina away from the layer beneath it. This does not cause a specific tear or
break in the retina.
The leading cause of traction retinal detachment is
proliferative retinopathy, a condition most frequently
caused by diabetes.
Exudative retinal detachment occurs when blood
or fluid from the middle layer of tissue that forms the eyeball (choroid) flows
into the space under the retina and separates the retina from the layer beneath
it. The detachment does not involve tears in the retina or traction from the
Exudative retinal detachment is most often a complication of other
diseases or conditions. These can include severe
macular degeneration, eye tumors, inflammation in the
choroid or the retina, or severe high blood pressure.
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