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Symptoms
Patients with RRD may have:
Signs
The key sign is an elevation of the retina from the retinal pigment epithelium (RPE) by fluid in the sub-retinal space. Indirect ophthalmoscopy with scleral depression may show the full-thickness retinal break or tear. The detached retina may be translucent and corrugated in appearance. Unlike an exudative detachment, the sub-retinal fluid does not shift with eye or head movements. There may be pigmented cells in anterior vitreous (tobacco dust, Shafer's sign) and an associated PVD or occasionally a vitreous haemorrhage. Intraocular pressure may be relatively reduced in the affected eye and an afferent pupillary defect may be noted if the detachment is severe. If the RRD is long standing, there is often a pigmented demarcation line at the posterior extent of the detachment. There may also be associated intraretinal cysts or white sub-retinal precipitates.
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