Retinal detachment occurs when the retina separates from its normal position. The retina is the light-sensitive layer at the back of the eye, responsible for capturing light and sending signals to the brain to form images. It's delicate, like wet tissue paper, making it vulnerable to detachment.

Causes include trauma (e.g., blunt force to the eye), retinal degeneration (often due to aging, leading to thinning of the retina and melting of the vitreous humor), tumors (like retinoblastoma, which can push the retina), hemorrhage (new blood vessels bleeding into the eye, common in diabetes mellitus), cataract surgery (accidental puncture during the procedure), and severe myopia (elongated eyeball causing compression and detachment of the retina).

Key symptoms include painless blurring of vision, as the retina lacks pain receptors. The first vision to go is often central vision. Patients may experience 'curtain-like vision' due to the falling retina, floating black spots (indicating red blood cells from bleeding), and flashes of light (signifying hypoxic or dying retina). Retinal detachment is typically unilateral, affecting one eye, unless trauma affects both.

Diagnosis is done through ophthalmoscopic examination, visualizing the back of the eye. Management involves providing bed rest and covering both eyes to immobilize them and prevent further detachment. Positioning the head as prescribed by the physician (often semi-Fowler's position if not specified) and protecting the eye from injury are also crucial. Speaking before approaching the patient is necessary as their eyes are covered.

Surgical options include cryosurgery (using extreme cold) and diathermy (using heat) to induce inflammation, helping the retina reattach to the choroid. Photocoagulation uses a laser for small tears. Scleral buckling involves placing a silicone band around the eyeball to compress it and reattach the retina.

Post-operative nursing care includes applying a bilateral eye patch for immobilization, bed rest for 1-2 days, and expecting redness and swelling. Monitoring for hemorrhage and intraocular pressure (IOP) is vital, especially during the first 24 hours. Patients are encouraged to practice deep breathing over coughing to avoid increasing IOP. Limiting reading for 3-5 weeks prevents rapid eye movement, and wearing dark glasses during the day protects the eye. Activities that increase IOP, like coughing, sneezing, heavy lifting, and bending, should be avoided to prevent further complications.