Clinical Examination

• Often difficult to exclude retinal detachment with ophthalmoscopy
• Dilate the pupil with phenylephrine 2.5% and tropicamide 1% eye drops (avoid if there is a history of angle-closure glaucoma)
• Measure visual acuity (reduced if the macula is detached)
• Check for an RAPD (present if there is a large retinal detachment)
• Early retinal detachments and retinal breaks occur in the periphery so look into all quadrants
• Examine the fellow eye

Inferior retinal detachment

Source: retinagallery.com, uploaded by Jason Calhoun

Horseshoe tear far periphery

Source: retinagallery.com, uploaded by Jason Calhoun

Bullous superior retinal detachment

Source: retinagallery.com, uploaded by Steven Cohen