Purpose To report the clinical features and surgical and visual outcomes of rhegmatogenous retinal detachment (RRD) in the paediatric population.

Methods A retrospective review of children (aged 0–15 years) who underwent primary surgical repair for RRD at the Hiroshima University Hospital between 1988 and 2001.

Results In all 53 eyes of 49 patients were identified; paediatric RRD accounted for 3.1% of 1779 eyes with RRD operated on during this period. The causes of RRD included blunt trauma (27%), myopia (25%), idiopathic (20%), familial exudative vitreoretinopathy (13%), and others. Among 55 eyes, 12 (22%) already had proliferative vitreoretinopathy (PVR) of grade C or D preoperatively. The median initial visual acuity (VA) was 0.3. Retinal reattachment was achieved with a single operation in 78%. Final retinal reattachment was achieved in 87%. Retinal reattachment rates with and without PVR were 42% and 100%, respectively (P< 0.01). Median final VA was 0.7. Final VA was⩾ 0.1 in 73% and⩾ 0.5 in 53%; four eyes had a final VA of no light perception. The presence of preoperative PVR (P= 0.03) and the initial VA (P< 0.0001) significantly affected final VA.

Conclusions Paediatric RRD is characterised by a delay in diagnosis, as evidenced by the high rate of PVR at presentation. Retinal reattachment was adversely affected by the presence of PVR. Final VA correlated with the initial VA and was significantly affected by preoperative PVR. Early diagnosis may improve the visual prognosis of paediatric retinal detachment.