Retinal Detachment

Retinal detachment is a serious eye condition that can lead to severe vision loss or blindness. It is a medical emergency that requires prompt treatment to save eyesight.

What is retinal detachment?

The retina is a layer of tissue that lines the inner back wall of the eye. The retina contains two types of light sensitive cells called photoreceptors, which detect light intensity and color. The retina converts this information into signals that are sent directly to the brain via the optic nerve. Retinal detachment occurs when retinal tissue peels away from the inner surface of the eyeball. The areas of the retina that detach from the back wall of the eye lose their blood supply and may begin to die.

Causes of retinal detachment

The exact cause of retinal detachment is not always known. Certain factors increase the risk of developing retinal detachment, including: 

  • aging 
  • eye conditions such as age-related macular degeneration, diabetic retinopathy, posterior vitreous detachment, retinoschisis, uveitis — an inflammation inside the eye — or lattice degeneration — a thinning of the retina
  • extreme myopia, or nearsightedness 
  • eye injury or surgery
  • genetic factors/family history of retinal detachment
  • medical conditions such as high blood pressure or eye tumors

Types of retinal detachment

There are three types of retinal detachment:

  • Rhegmatogenous retinal detachment, the most common type, occurs due to small tears or breaks in the retina. The gel-like vitreous inside the eye gets behind the retina and pushes it away from the layer beneath.
  • Tractional retinal detachment occurs when abnormal tissue, such as a scar, forms on the retina surface, pulling the retina away from the back of the eye.
  • Exudative retinal detachment occurs when blood or fluid builds up behind the retina, separating it from the layer underneath.

Signs and symptoms of retinal detachment

Retinal detachment usually occurs in one eye but can sometimes involve both eyes. Symptoms may come on slowly or occur suddenly, and may include: 

  • blurred vision
  • flashing lights 
  • floaters, which are spots or thread-like shapes that float across the field of vision
  • shadows that move over the visual field like a dark curtain or veil

How is retinal detachment diagnosed?

To diagnose retinal detachment, an eye specialist (ophthalmologist) will conduct a dilated eye examination. After placing drops in the eyes to dilate the pupils, the ophthalmologist will use special devices to inspect the retina for holes, tears or signs of detachment. If there is bleeding inside the eye, an ultrasound procedure can help reveal the exact position of the retina. In addition, an optical coherence tomography scan may be needed to obtain high resolution cross-section images of the retina.

Treatments for retinal detachment

Treatment methods for retinal detachment depend on the extent and location of the damage, with options ranging from non-invasive procedures to surgery. 

  • Cryoplexy uses a freezing probe to create a small scar that holds the retina in its proper position. 
  • Photocoagulation uses a medical laser to seal tears in the retina. Laser surgery can also secure a detached retina to the back wall of the eye.
  • Pneumatic retinopexy, involves injecting a small air bubble into the eye to press the retina back into place.
  • Scleral buckle is a tiny flexible band placed around the outside of the eye to hold the retina in place and help it reattach to the back wall.
  • Vitrectomy involves removing vitreous humor, the gel-like fluid that fills the eyeball, to make space to perform a variety of repairs. Afterward, the vitreous humor is replaced with saline or silicone oil, which hold the retina in place.