Retinal detachment refers to the separation of the inner sensory layer of the retina from the outer epithelium, leading to a loss of retinal function.

Detachment of the retina is caused by a hole in the inner layer that allows fluid from the vitreous body to leak under the retina and peel it off from its innermost layer. This hole or break may occur from trauma or diseases that cause retinopathy, such as diabetes mellitus (see diagnostic code: 7913 diabetes mellitus).

Some common symptoms may include: loss of visual acuity; blurred vision; flashes of light; and vitreous floaters. There is no pain associated with detachment. Macula involvement causes failure of central vision.

Tests that may be used to diagnose the condition include: visual fields; visual acuity; ophthalmoscopy; slit lamp examination; soft tissue x-ray; computed tomography (CT) scan; ultrasonography; and fluorescein staining.

Treatment will vary according to the type of retinal detachment. Simple cases are treated with lasers and cryotherapy and the more complicated cases with retinal and vitreous surgery.

Late-onset glaucoma may occur months or years later as a result of hyphema. Long-term complications from chemical burns include: glaucoma, corneal scarring, and entropion (see diagnostic code: 6021 entropion). Excessive exposure to x-ray or nuclear radiation may produce cataract changes that will appear after many months. Rupture of the scleral wall may result in cataract development weeks after the injury.

• Consider entitlement to Auto and auto adaptive equipment under 38 CFR 3.308 if there is permanent impairment of vision in both eyes consisting of central visual acuity of 20/200 or less in the better eye, with corrective glasses, or central visual acuity of more than 20/200 if there is a field defect in which the peripheral field has contracted to such an extent that the widest diameter of visual field subtends an angular distance no greater than 20° in the better eye.

• Consider entitlement to specially adapted housing under 38 U.S.C. 2101(a)(2)(A)(i) if there is visual impairment to the degree specified in 38 CFR 3.809(b)(2).

• Review for potential entitlement to special monthly compensation under 38 CFR 3.350 when there is loss/loss of use of one or both eyes, light perception only; visual acuity 5/200 or less; the vision field is reduced to 5 degree concentric contraction in both eyes; or blindness with no light perception in one or both eye.

• Evaluate on the basis of either visual impairment due to the particular condition or on incapacitating episodes, whichever results in a higher evaluation.

• For the purposes of evaluation under 38 CFR 4.79, an incapacitating episode is an eye condition severe enough to require a clinic visit to a provider specifically for treatment purposes.

• Examples of treatment may include but are not limited to: Systemic immunosuppressants or biologic agents; intravitreal or periocular injections; laser treatments; or other surgical interventions.

• For the purposes of evaluating visual impairment due to the particular condition, refer to 38 CFR 4.75, 38 CFR 4.76, 38 CFR 4.77, 38 CFR 4.78,  and  38 CFR 4.79, diagnostic codes 6061-6091.