The commonest cause of retinal detachment (RD) is a retinal tear (known as a rhegmatogenous RD) which occurs as a consequence of a posterior vitreous detachment (PVD). The vitreous, which liquefies with age, separates away from the retina (either spontaneously or due to trauma) and in some patients vitreo-retinal traction results in one or more retinal breaks. Any retinal break can lead to a detached retina by allowing liquid vitreous to separate the sensory retina from the retinal pigment epithelium (RPE).
Myopic patients are particularly at risk of RD as long axial length eyes are more prone to earlier PVD’s and the peripheral retina is often thin and weaker eg lattice retinal degeneration. Less commonly RD can occur in the absence of retinal breaks eg tractional RD in proliferative diabetic retinopathy or exudative RD in posterior sceritis.