Approach

RD should be suspected in any patient with sudden appearance of disturbance in the visual field and/or loss of central vision. Presenting complaints of flashes of light or sudden 'floaters' suggest a retinal break or detachment has occurred. Sudden disturbance in the visual field and/or loss of central vision may suggest a major vitreous haemorrhage. All should prompt urgent referral to an ophthalmologist.

In the vast majority of cases, the patient with a rhegmatogenous RD has 'out-of-the-blue' visual symptoms (i.e., loss of vision) severe enough to seek evaluation by an ophthalmologist. In a few cases, presence of the RD is accidentally discovered by the ophthalmologist on routine fundus examination or by the patient when he or she covers the good eye.

Non-rhegmatogenous RDs may develop very slowly (tractional), rather rapidly (exudative), or instantaneously (haemorrhagic). Flashes of light signifying acute retinal traction are much rarer in non-rhegmatogenous RDs because of the slow progression of the condition.

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