Management of Pediatric Rhegmatogenous Retinal Detachment

Pediatric rhegmatogenous retinal detachment (RRD) presents unique challenges in diagnosis and management. A thorough evaluation of family, medical, and ocular history is helpful, as systemic and genetic conditions can predispose children to RRD. Trauma, high myopia, and history of prematurity are also common risk factors. Examining young children in the outpatient setting may have limitations, but the yield can be maximized by modifying examination techniques and utilizing imaging technologies. In this manscript, the considerations for diagnosis and management of pediatric rhegmatogenous retinal detachment are outlined.

Primary scleral buckling is the treatment of choice for the vast majority of pediatric RRDs, as it offers a higher single surgery success rate in these young eyes with firmly adherent posterior hyaloid. Primary vitrectomy is not recommended due to this reason. Scleral buckling is the mainstay of pediatric RRD surgery, even in cases that may typically undergo vitrectomy in adults. Prophylactic treatment of the fellow eye may also be warranted in certain clinical scenarios. Understanding the unique challenges these patients face is important for early diagnosis, timely intervention, and tailored surgical strategies to optimize visual outcomes in this vulnerable patient population.