What is 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. In some cases there may be small areas of the retina that are torn. These areas, called retinal tears, can lead to retinal detachment. If not promptly treated, retinal detachment can cause permanent vision loss.
Types of Retinal Detachment
Rhegmatogenous - A tear or break in the retina that allows fluid to get under the retina and separate it from the retinal pigment epithelium (RPE), the pigmented cell layer that nourishes the retina. This type of retinal detachment is the most common.
Tractional - In this type of detachment, scar tissue on the retina’s surface contracts and causes the retina to separate from the RPE.
Exudative - Frequently caused by retinal diseases or injury or trauma to the eye. In this type, fluid leads into the area underneath the retina, but there are no tears or breaks in the retina.
Symptoms of Retinal Detachment
Symptoms include a sudden or gradual increase in either the number of floaters and/or light flashes in the eye. Floaters are little “cobwebs” or specks that float about in your field of vision. Another symptom is the appearance of a curtain over the field of vision. A retinal detachment is a medical emergency. Anyone experiencing the symptoms of a retinal detachment should see an eye care professional immediately.
Treatment for Retinal Detachment
Small holes and tears are treated with laser surgery called cryopexy. During laser surgery tiny burns are made around the hole to fuse the retina back into place. Cryopexy freezes the area around the hole and helps reattach the retina.
In other cases, a scleral buckle, or tiny synthetic band, is attached to the outside of the eyeball to gently push the wall of the eye against the detached retina. If necessary a vitrectomy may also be performed. During a vitrectomy the doctor makes a tiny incision in the sclera, or white of the eye. Next, a small instrument is placed into the eye to remove the vitreous, a gel-like substance that fills the center of the eye and helps the eye maintain a round shape. Gas is often injected into the eye to replace the vitreous and push the retina back against the wall of the eye to reattach the retina. During the healing process, the eye makes fluid that gradually replaces the gas and fills the eye. With all of these procedures, either a laser or cryopexy is used to fuse the retina back in place.
With modern therapy, over 90 percent of those with a retinal detachment can be successfully treated, although sometimes a second treatment is needed. The visual outcome however, is not always predictable. The final visual result may not be known for up to several months following surgery.
Even under the best circumstances, and even after multiple attempts at repair, treatment sometimes fails and vision may eventually be lost. Visual results are best if the retinal detachment is repaired before the macula, or center region of the retina, detaches. That is why it is important to contact an eye care professional immediately if you see a sudden or gradual increase in the number of floaters and/or light flashes, or a dark curtain over the field of vision.