Retinal Detachment, Facts About

What is retinal detachment?

Retinal detachment is a condition in which a layer of tissue called the retina gets lifted or pulled away from its normal position in the eye. The retina acts as a light-sensitive wallpaper in the eye, lining the inside of the eye wall and sending visual signals to the brain.

If a person with retinal detachment is not treated right away, he or she can have permanent vision loss.

Sometimes small areas of the retina get torn. These are called retinal tears or retinal breaks. These can lead to retinal detachment.

What are the symptoms of retinal detachment?

Symptoms of retinal detachment include:

  • An increase in floaters – Floaters look like little "cobwebs" or specks that float about in the field of vision. This increase can happen all of a sudden or slowly over time.
  • Seeing flashes of light
  • Seeing a curtain that causes a loss of a field of vision. This curtain might originate from any direction.

A retinal detachment is a medical emergency. If you or someone you know has these symptoms, see an eye doctor immediately.

What are the different types of retinal detachment?

There are three types of retinal detachment. They include:

  • Rhegmatogenous – In this type, a tear or break allows fluid to get under the retina and separate it from the retinal pigment epithelium (RPE). The RPE is a layer of cells that nourishes the retina. These types of retinal detachments are the most common. They are also the most dangerous type, since they progress rapidly.
  • Tractional - In this type, scar tissue on the retina's surface shrinks and causes it to separate from the RPE. This type of detachment occurs in people with diabetes. It does not progress as rapidly.
  • Exudative – In this type, fluid leaks into the area underneath the retina, but there are no tears or breaks in the retina. This type is usually caused by retinal diseases, including inflammatory disorders and injury or trauma to the eye.

Who is at risk for retinal detachment?

Retinal detachment is more common in people over age 40. But it can happen at any age. It affects men more than women, and Whites more than African Americans.

Other people at risk for retinal detachment include those who:

  • Are extremely nearsighted
  • Have had a retinal detachment in the other eye
  • Have a family history of retinal detachment
  • Have had cataract surgery
  • Have other eye diseases or disorders, such as retinoschisis, uveitis, degenerative myopia, or lattice degeneration
  • Have had an eye injury

How is retinal detachment treated?

There are many treatment options for retinal detachment.

Some of these treatments help with small holes and tears. These can be performed in the eye doctor's office, and include:

  • Laser surgery – Laser surgery can treat small holes and tears. Tiny burns are made around the hole to "weld" the retina back into place. It is performed in the eye doctor's office.
  • Cryopexy – This is a freeze treatment that can also help with small holes and tears. Cryopexy freezes the area around the hole and helps reattach the retina. This procedure is performed in the eye doctor's office.
  • Gas injection – For this treatment, the eye doctor injects a gas bubble into the eye. The doctor might do this in addition to the laser or cryopexy treatment. The gas bubble can help hold the retina against the eye wall while the areas treated with laser or cryopexy reattach at full strength, which can take up to a week.

Most cases of retinal detachment are treated with surgery. This might include:

  • Scleral buckle – This is a tiny synthetic band that the doctor attaches to the outside of the eyeball. The band gently pushes the wall of the eye in toward the center of the eye. This places the eye wall very close to the detached retina. Natural pumps in the eye then help reattach the retina to the wall.
  • Vitrectomy – A vitrectomy is a surgery to replace the vitreous, a gel-like substance that fills the center of the eye and helps the eye maintain a round shape. During a vitrectomy, the doctor makes a tiny incision in the white of the eye. Next, he or she uses a small instrument to remove the vitreous. In most cases, the doctor injects gas to replace the vitreous. The gas pushes the retina back against the wall of the eye and reattaches it. As it heals, the eye makes fluid that slowly replaces the gas and fills the eye.

With both of these surgeries, either laser or cryopexy are used to "weld" the retina back in place.

With modern therapy, most people can be successfully treated for retinal detachment, but doctors cannot always predict how vision will turn out. The visual outcome might not be known for up to several months after surgery.

Sometimes a second treatment is needed. Unfortunately, sometimes vision cannot be restored even with multiple treatments. In many cases, it depends on how severe the retinal detachment was, and how much time passed before the person was treated.

Results are best if the retinal detachment is treated as soon as possible. That is why it is important to see an eye doctor immediately if you have any symptoms of a retinal detachment.

This information was adapted from information provided by the National Eye Institute (NEI) to help patients and their families in searching for general information about retinal detachment. You should always talk with one of our medical experts who has examined the patient's eyes and is familiar with his or her medical history to answer specific questions.