Summary
Definition
History and exam
Key diagnostic factors
- loss or deterioration of central vision
- flashes of light
- loss of peripheral visual field
Other diagnostic factors
- floaters
Risk factors
- posterior vitreous detachment
- increasing age
- myopia
- previous cataract surgery
- trauma
- previous ophthalmic surgery
- intraocular tumor
- vitreous hemorrhage
- affected fellow eye
- diabetes mellitus
- retinopathy of prematurity
- ocular inflammation/infection
- peripheral retinal degeneration
- anatomic abnormality
- age-related macular degeneration
- phosphodiesterase-5 inhibitor use in men
- genetic and vascular causes in childhood
- childhood tumors
Diagnostic investigations
1st investigations to order
- visual acuity testing
- slit-lamp exam
- indirect ophthalmoscopy
Investigations to consider
- wide-field color photography
- optical coherence tomography (affected eye)
- B-scan ultrasonography (affected eye)
- CT/MRI of orbit
Treatment algorithm
posterior vitreous detachment without break/tear
retinal hole/tear without detachment
rhegmatogenous RD
tractional RD
exudative RD
hemorrhagic RD
Contributors
Authors
Ferenc Kuhn, MD, PhD

Director of Clinical Research
Helen Keller Foundation for Research and Education
Associate Professor of Ophthalmology
University of Alabama at Birmingham
Birmingham
AL
Consultant and Chief Vitreoretinal Surgeon
Department of Ophthalmology
University of Pécs Medical School
Pécs
Hungary
Disclosures
FK declares that he has no competing interests.
Acknowledgements
Dr Kuhn would like to gratefully acknowledge Dr Robert Morris, a previous contributor to this monograph. RM declares that he has no competing interests.
Peer reviewers
David Steel, MBBS, FRCOphth
Consultant Ophthalmologist
Sunderland Eye Infirmary
Sunderland
UK
Disclosures
DS declares that he has no competing interests.
Michael W. Stewart, MD
Professor and Chairman of Ophthalmology
Mayo Clinic
Jacksonville
FL
Disclosures
MWS declares that he has no competing interests.
Ron Adelman, MD, MPH, FACS
Associate Professor of Ophthalmology
Yale University School of Medicine
New Haven
CT
Declarações
RA declares that he has no competing interests.
Scott Fraser, MD, FRCS (Ed), FRCOphth
Consultant Ophthalmologist
Sunderland Eye Infirmary
Sunderland
UK
Declarações
SF declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referências
Principais artigos
Kim SJ, Bailey ST, Kovach JL, et al. Posterior vitreous detachment, retinal breaks, and lattice degeneration preferred practice pattern®. Ophthalmology. 2025 Apr;132(4):P163-96.Texto completo
American Academy of Ophthalmology. Referral of persons with possible eye diseases or injury - 2014. Apr 2014 [internet publication].Texto completo
Hikichi T, Trempe CL. Relationship between floaters, light flashes, or both, and complications of posterior vitreous detachment. Am J Ophthalmol. 1994;117:593-8. Resumo
Znaor L, Medic A, Binder S, et al. Pars plana vitrectomy versus scleral buckling for repairing simple rhegmatogenous retinal detachments. Cochrane Database Syst Rev. 2019 Mar 8;(3):CD009562.Texto completo Resumo
Sena DF, Kilian R, Liu SH, et al. Pneumatic retinopexy versus scleral buckle for repairing simple rhegmatogenous retinal detachments. Cochrane Database Syst Rev. 2021 Nov 11;(11):CD008350.Texto completo Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
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