Retinal Detachment

Retinal detachment is a separation of the light-sensitive membrane in the back of the eye (the retina) from its supporting layers.

Causes, incidence, and risk factors

The retina is a transparent tissue in the back of the eye. It helps you see the images that are focused on it by the cornea and the lens. Retinal detachments are often associated with a tear or hole in the retina through which eye fluids may leak. This causes separation of the retina from the underlying tissues.

Retinal detachment often occurs on its own without an underlying cause. However, it may also be caused by trauma, diabetes, or an inflammatory disorder. It is most often caused by a related condition called posterior vitreous detachment.

During a retinal detachment, bleeding from small retinal blood vessels may cloud the interior of the eye, which is normally filled with vitreous fluid. Central vision becomes severely affected if the macula, the part of the retina responsible for fine vision, becomes detached.

The risk factors are previous eye surgery, nearsightedness, a family history of retinal detachment, uncontrolled diabetes, and trauma.

Symptoms

  • Bright flashes of light, especially in peripheral vision
  • Blurred vision
  • Floaters in the eye
  • Shadow or blindness in a part of the visual field of one eye

Signs and tests

A thorough dilated retinal exam by your ophthalmologist is performed to detect a retinal detachment.  If a retinal detachment is diagnosed early treatment is more straightforward.  It is critical for the patient to come in early if new floaters or a curtain of darkness is present in the vision.

Treatment

Patients with a retinal detachment will need surgery, either immediately or after a short period of time.  Types of surgery include:

  • Cryopexy (intense cold applied to the area with an ice probe) to help a scar form, which holds the retina to the underlying layer
  • Laser surgery to seal the tears or holes in the retina
  • Pneumatic retinopexy (placing a gas bubble in the eye) to help the retina float back into place

Laser surgery is performed after pneumatic retinopexy to permanently fix it in place. This is often done in a doctor’s office.

More extensive detachments may require surgery in an operating room. Such procedures include:

  • Scleral buckle to indent the wall of the eye
  • Vitrectomy to remove gel or scar tissue pulling on the retina

Expectations (prognosis)

The final visual result will depend on the location and extent of the detachment and early treatment. If the macula has not detached, the results of treatment can be excellent. Most retinal detachments can be repaired, but not all of them.

Complications

The unsuccessful reattachment of the retina results in loss of vision.

When to Call Us

A retinal detachment is an urgent problem that requires medical attention within 24 hours of the first symptoms. Call our office immediately.

Prevention

Use protective eye wear to prevent eye trauma. Control your blood sugar carefully if you have diabetes. See your eye care specialist at least yearly, especially if you have risk factors for retinal detachment such as high myopia or a family history of retinal detachment.


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