**Risk factors** - older age - degenerative myopia - previous retinal detachment **history** - shade over the eye; *peripheral*, becoming progressively more central - slow onset over hours - flashes and floaters due to: - blood in vitreous - retinal traction and stimulation - flashes usually in *temporal* field and brief. may be triggered by eye movement - zig sag lines that persist for minutes are usually migranous **exam** - partial field loss, curtain-like defect - acuity may be normal if macula not involved - an asymmetrical [[red reflex]] may be present - a [[Relative afferent pupillary defect|RAPD]] may also be present if large - Ultrasound **ultrasound** - 90% sensitive and specific - less sensitive for small tears - shows the detached retina as a highly echogenic thin membrane in the posterior chamber - it is attached to the optic nerve posteriorly and the anteriolateral orbit (ora serrata) on both sides - forms a V shape btwn its attachment points - ==features of associated [[Vitreous haemorrhage]] may also be present== **Treatment** - pad eye - bed rest - refer for possible laser photo coagulation within 24 hours - ?bubble treatment