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Educational draft · awaiting clinical reviewUse Rapid for revision, not patient-care decisions. Check current national and local guidance and the BNF or BNFC before acting.
RapidMLAMSRAGP

Retinal tear and rhegmatogenous detachment

Essential points for quick revision.

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Protect an attached macula

A retinal break can allow fluid beneath the retina, with a spreading detachment threatening central sight when it reaches the macula.

Action: Arrange immediate contact with the emergency retinal service for a suspected detachment, especially when central vision remains preserved. Record symptom onset and visual function without delaying transfer. A detachment that already affects central vision still requires urgent specialist assessment and treatment planning.

Synopsis

Recognise retinal breaks and detachment, understand why macular involvement changes visual prognosis, and coordinate urgent retinal treatment and clear postoperative safety advice.

  • Rhegmatogenous detachment requires a full-thickness retinal break through which fluid reaches the subretinal space.
  • Vitreous traction commonly contributes to tearing; myopia, previous ocular surgery and trauma are relevant risk factors.
  • The presentation is usually painless, with photopsia, new floaters and a fixed or enlarging field shadow.

Key red flags

A progressive curtain or missing field following flashes or floaters requires emergency same-day retinal assessment.

Investigation priorities

01
Acuity, pupils and visual fieldsFirst step

Document function and establish information needed for urgent handover.

Management branches

Suspected detachmentSecure emergency retinal assessment

A new fixed shadow, visual decline or examination finding suggests retinal separation.

  1. Contact the receiving retinal service immediately, communicating onset, field change, acuity and whether central vision remains intact.
  2. Provide the relevant history of trauma, prior surgery, fellow-eye disease and antithrombotic medicines, and arrange safe transport.
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Sources and review status6 sources · checked 7 Sept 2026 · clinical review pending
Sources

Sources and review status

National guidance is shown before implementation-dependent detail. Typical adult dose examples remain subject to patient factors, contraindications and the live BNF or specialist protocol. Source check completed 7 Sept 2026; clinical approval remains outstanding.

Authoring stateRapid draftClinical stateAwaiting reviewJurisdictionUnited Kingdom