Core Messages

• Retinal detachment in childhood is uncommon and has a different range of aetiologies from adult retinal detachment

• It often presents late or with involvement of the fellow eye

• High myopia, particularly if congenital, usually indicates an underlying abnormality

• Retinal dialysis is not associated with posterior vitreous detachment

• Giant retinal tear is usually associated with abnormal gel and an underlying hereditary vitreoretinopathy and should be differentiated from dialysis because it has a different prognosis and requires different management

• Stickler syndrome is the commonest inherited cause of retinal detachment with a lifetime risk of more than 60%

• Stickler syndrome may have no systemic features and can be diagnosed purely on the vitreous phenotype

• Many causes of retinal detachment in childhood are associated with an underlying developmental abnormality which may limit the prognosis for good vision

• There is a real case for offering prophylactic treatment to prevent retinal detachment where there is a familial risk of giant retinal tear

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