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" my question is will an untreated detached retina not cause pain"- to answer to this query is NO. Retinal detachment(RD) is PAINLESS. It usually presents as a sudden blurring/loss of vision in one or more quadrants of the visual field. Coat's disease is known to cause exudative retinal detachment as one of its complications.
In case of long standing RD the prognosis is very poor as the chances of the retina falling back inot its place and getting reattached is very unlikely. The prognosis and visual outcome is better in case of fresh RD say within a few days of its onset. In this case the exact duration of RD is not known hence the lesser likelihood of visual recovery.
If the disease is not halted with the help of lasers , it may continue to have new blood vessel formation, cause glaucoma,cataract. As the central vision has been lost and RD has developed , the purpose of treatment would be prevent glaucoma. In a few number of cases, if the eye becomes a painful blind eye, it may require an enucleation. If there is no pain and some amount of vision, a more of symptomatic approach is taken such as keep the intraocular pressure under control if found high.
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