Retinal Detachment

The retina is the light-sensitive layer of tissue that lines the inside of the eye and sends visual messages through the optic nerve to the brain. When the retina detaches, it is lifted or pulled from its normal position. The retina cannot properly operate when it is detached, and permanent vision loss may occur if the retina is not promptly repaired.

Retinal detachments can occur at any age, but they are most common in individuals over the age of 40. More men develop detachments than women. Certain individuals are more likely to get a detached retina if they have any of the following conditions:

  • Severe nearsightedness
  • Eye injury
  • Cataract surgery
  • Detached retina in the other eye
  • Family history of retinal detachments

Types of Retinal Detachments

There are three types of retinal detachments:

  • Rhegmatogeneous— This is the most common type or retinal detachment. A tear in the retina allows fluid to get under the retina and separate it from the retinal pigment epithelium (RPE), the cell layer that nourishes the retina.
  • Tractional— This is caused when scar tissue on the retina’s surface contracts and pulls the retina away from the RPE. This type of retinal detachment is seen in diabetics and premature babies and is much less common.
  • Exudative— This type of detachment is often caused by trauma, injury, inflammation or other eye diseases. Fluid leaks into the area under the retina but causes no tears or breaks.

Warning Signs and Symptoms

A detached retina does not receive oxygen, and the cells in the retina begin to die. This is why retinal detachment is an eye emergency that requires immediate treatment. Detachment causes no pain, but there are some warning signs that are recognizable. One symptom is a gradual or sudden increase in either the number of floaters, or specks, in the field of vision, and/or light flashes in the eye. Another symptom is the appearance of a curtain over the field of vision or a darkening of the peripheral vision. A retinal detachment is an urgent medical condition. Anyone experiencing the symptoms of a retinal detachment should see an eye care professional.

Tests to Diagnose Retinal Detachment

When your eye is dilated as part of an eye exam, your ophthalmologist can detect a detached retina. If you have a family history of detached retinas or if you have had eye injury or cataract surgery, talk to your eye doctor about how often you should get your eyes checked. Certain conditions such as diabetes make you more prone to have eye disease. Early diagnosis is critical in preventing permanent vision loss.

Treatments and Procedures

A variety of treatment options are available to treat retinal detachment, depending on the severity of the problem.

  • Thermal or cryopexy treatment uses either heat or freezing to repair the tear in the retina. These procedures are effective when the detachment is discovered in the early stages. Treatment usually takes place at an outpatient facility.
  • Scleral buckling places a flexible silicone band around the eye to compress it inward until the tear heals. The band is not visible and remains permanently attached. This procedure is usually done under general anesthesia. Thermal or cryo treatment is necessary to seal the tear.
  • Vitrectomy is effective for large retinal tears. It uses a small instrument to release the tension on the retina. Clear fluid between the lens and retina is removed and replaced with gas, saline or silicone oil. This can usually be done under local anesthesia.
  • Pneumatic retinopexy is a procedure that treats small tears that are easy to close. A small gas bubble is injected into the vitreous to push the retina tear closed. This is usually performed with local anesthesia. Thermal or cryopexy treatment follows to seal the tear.

What are the Possible Outcomes?

With modern therapy, most retinal detachments can be successfully treated, but sometimes it takes several months to determine the final visual outcome. Sometimes, a second treatment is necessary to restore the retina. Although a retinal reattachment often does not require you to stay overnight at a hospital, you will have to limit your physical activity to allow your eye to heal. Therefore, rest is important for a full recovery.

Staying current with your comprehensive eye exams is essential for prevention of retinal tears. This is especially important for those who are at higher risk for developing retinal tears. See your doctor immediately if you notice any of the warning signs or symptoms of a retinal detachment.