A detached retina is a serious and sight-threatening event, occurring when the retina becomes separated from its underlying supportive tissue. The retina cannot function when these layers are detached. And unless the retina is reattached soon, permanent vision loss may result.
Detached Retina Symptoms and Signs
If you suddenly notice spots, floaters and flashes of light, you may be experiencing the warning signs of a detached retina. Your vision might become blurry, or you might have poor vision. Another sign is seeing a shadow or a curtain descending from the top of the eye or across from the side.
These signs can occur gradually as the retina pulls away from the supportive tissue, or they may occur suddenly if the retina detaches immediately.
About one in seven people with sudden onset of flashes and floaters will have a retinal tear or detachment, according to a study reported in late 2009 in the Journal of the American Medical Association. Up to 50 percent of people who experience a retinal tear will have a subsequent detachment.
No pain is associated with retinal detachment. If you experience any of the signs, consult your eye doctor right away. Immediate treatment increases your odds of regaining lost vision.
What Causes Retinal Detachments?
An injury to the eye or face can cause a detached retina, as can very high levels of nearsightedness. Extremely nearsighted people have longer eyeballs with thinner retinas that are more prone to detaching.
On rare occasions, a detached retina may occur after LASIK surgery in highly nearsighted people. In a study of more than 1,500 LASIK patients, just four suffered retinal detachment; their pre-LASIK prescriptions ranged from -8.00 D to -27.50 D.
Cataract surgery, tumors, eye disease and systemic diseases such as diabetes and sickle cell disease also may cause retinal detachments.
New blood vessels growing under the retina which can happen in diseases such as diabetic retinopathy may push the retina away from its support network as well.
Sometimes fluid movement in the eye pulls the retina away.
Treatment for Detached Retina
Surgery is required to repair a detached retina. The procedure usually is performed by a retinal specialist an ophthalmologist who has undergone advanced training in the medical and surgical treatment of retinal disorders.
Seeing a shadow coming down across your field of vision is a sign of retinal detachment. (If you can't see the image, you may need Flash Player.)
Generally, the sooner the retina is reattached, the better the chances that vision can be restored.
Surgical procedures used to treat a retinal detachment include:
- Scleral buckling surgery. This is the most common retinal detachment surgery, and consists of attaching a small band of silicone or plastic to the outside of the eye (sclera). This band compresses (buckles) the eye inward, reducing the pulling (traction) of the retina and thereby allowing the retina to reattach to the interior wall of the eye.
The scleral buckle is attached to the posterior portion of the eye and is invisible after surgery.
Scleral buckling surgery often is combined with one of the following procedures to fuse the retina to its underlying supporting tissue (called the retinal pigment epithelium, or RPE).
- Vitrectomy. In this procedure, the clear jelly-like fluid is removed from the posterior chamber of the eye (vitreous body) and replaced with clear silicone oil to push the detached portion of the retina back onto the RPE.
- Pneumatic retinopexy. In this procedure, the surgeon injects a small bubble of gas into the vitreous body to push the detached portion of the retina onto the RPE.
If the detachment is caused by a tear in the retina, the surgeon usually uses a laser or a freezing probe to "spot weld" the retina firmly onto the RPE and underlying tissues and thereby seal the tear. If a laser is used, this is called laser photocoagulation; use of a freezing probe is called cryopexy.
Surgical reattachment of the retina isn't always successful. The odds for success depend on the location, cause, and extent of the retinal detachment, along with other factors.
Also, successful reattachment of the retina doesn't guarantee normal vision. Generally, visual outcomes are better after surgery if the detachment is limited to the peripheral retina and the macula is not affected.
Judith Lee also contributed to this article.
[Page updated July 2011]
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