Retinal Detachment: Causes & Treatments

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What is Retinal Detachment?

Retinal detachment occurs when the eye’s retina separates from its position. The retina is the thin layer of tissue located at the back of the eye. 

When detachment occurs, retinal cells cannot get the nourishment and oxygen needed from blood vessels.

Early warning signs of retinal detachment include seeing “floaters” or “flashers” or experiencing reduced vision.

How Serious is a Detached Retina? 

Retinal detachment is a medical emergency and requires immediate attention. Left untreated, even for a short time, can result in blindness. 

Who is at Risk for Retinal Detachment?

Anyone can experience retinal detachment, but some people have a higher risk. 

Risk factors for retinal detachment include:

  • Advanced age (50 and older)
  • Family history of retinal detachment
  • Extreme myopia (nearsightedness)
  • Previous retinal detachment in one eye (the other eye is at higher risk once detachment occurs in one eye)
  • Previous eye surgery, especially cataract removal
  • Eye diseases, including uveitis, lattice degeneration, retinoschisis
  • Previous severe eye injuries
  • Diabetes

Symptoms of Retinal Detachment

Symptoms of retinal detachment include: 

  • Sudden appearance of dark specks in your field of vision (floaters)
  • Flashes of light
  • Reduction in peripheral vision
  • Blurred vision
  • “Curtain” shadow that slides over your field of vision

Retinal detachment is painless. Do not assume that lack of discomfort or pain means there isn’t a problem. 

If you experience any of the above symptoms, you should contact your eye doctor immediately and/or seek immediate medical attention.

What Causes a Detached Retina?

The cause of retinal detachment varies from person to person. It is often linked to other health concerns, including:

  • Nearsighted vision
  • Eye trauma or injury
  • Previous cataract surgery
  • Advanced diabetes
  • Eye diseases and disorders

The cause of retinal detachment is linked to the type of retinal detachment someone experiences. 

There are three types of retinal detachment, including:

Rhegmatogenous 

The most common type of retinal detachment (rhegmatogenous retinal detachment) is caused by a tear or hole in the retina that permits fluid to pass into and collect beneath the retina. 

Gradually, the retina pulls away, causing blood loss and a decrease in vision. 

This type of retinal detachment is usually linked to age. As someone ages, the vitreous liquid in their eyes changes consistency. 

If it separates and peels, it can tug on the retina, causing a tear that eventually leads to detachment.

Tractional 

This type of retinal detachment is caused by the growth of scar tissue on the retina’s surface that pulls at the retina. 

This is most common in people with out-of-control diabetes or other health conditions that affect vision.

Exudative 

This type of retinal detachment results when fluid accumulates behind the retina due to injury, macular degeneration, inflammatory disorders, or tumors. 

There are no holes or tears in the retina, but as more fluid accumulates, it causes separation and detachment.

Diagnosing & Treating Retinal Detachment

A doctor must diagnose and treat retinal detachment. Tests used to diagnose detachment include:

Dilated Retinal Exam 

Doctors use bright lights and special lenses to view the retina and the back of the eye and determine if there is a hole, tear, or detachment.

Ultrasound

If there is bleeding in the eye that makes it difficult to examine the retina, your doctor might order an ultrasound to get a better view of the back of the eye. 

If the examination reveals no holes or tearing despite your symptoms, your doctor will schedule a follow-up visit. If you experience any additional or new symptoms before the follow-up visit, it’s important to contact your doctor. 

If the examination reveals detachment, your doctor will order surgery within hours or days of the exam. There are three surgical procedures used to repair detachment, including:

Pneumatic retinopexy

This procedure injects gas or air into the vitreous cavity in the center of the eye. The bubble of air pushes the damaged part of the retina against the eye’s wall, which stops the flow of fluid behind the retina. 

Once they’ve halted the flow, the surgeon uses cryopexy or laser to repair the retinal tear. The bubble of air or gas and any liquid is absorbed into the eye, allowing the retina to adhere back into place. 

Scleral buckling 

This procedure uses a silicone material that is sewn in place by the surgeon to cover the sclera (white of the eye). 

It creates an indentation in the wall of the eye and relieves the tugging and pulling on the retina by the vitreous liquid that has accumulated. 

The silicone cover doesn’t block vision and can remain in place forever. If there are multiple holes, the surgeon can attach several covers that encircle the eye with support.

Vitrectomy

This procedure drains the accumulated vitreous and uses air, gas, or silicone oil to fill the vitreous space and flatten the retina. 

The injected material is eventually absorbed and the space refills with fluid. 

In some cases, the fluid must be surgically removed several months after the procedure. Vitrectomy is often used in combination with scleral buckling.

Vision usually improves gradually in the months following the procedure. Sometimes a second procedure is needed to further improve vision. 

In other cases, vision is never completely restored. 

Can a Retinal Detachment Heal on Its Own?

No.

Left untreated, retinal detachment gets worse and can lead to permanent vision loss

Retinal detachment must be treated by a medical professional and requires surgery to correct. This is the only way to reattach the retina so it can receive the blood supply it needs to remain healthy.

How to Prevent Retinal Detachment 

There is no way to prevent retinal detachment. However, there are some things you can do to reduce your risk. 

It’s also important to recognize the symptoms of retinal detachment and seek medical attention as soon as possible. People who are at higher risk of retinal detachment from medical issues or previous detachment or vision issues should schedule yearly eye exams.

Resources
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(1) “Retinal Detachment | National Eye Institute.” Nih.gov, 2019.

(2) “Retinal Detachment - Symptoms and Causes.” Mayo Clinic, 2019.

(3) “Retinal Detachment (Detached Retina): Symptoms, Treatment & Prevention.” Cleveland Clinic.

(4) “Retinal Detachment.” Medlineplus.gov, medlineplus.gov/retinaldetachment.html.

(5) Retinal Detachment: What Is a Torn or Detached Retina. “Retinal Detachment: What Is a Torn or Detached Retina?” American Academy of Ophthalmology, Mar. 2016.

(6) Harvard Health Publishing. “Top Foods to Help Protect Your Vision - Harvard Health.” Harvard Health, Harvard Health, Aug. 2013. 

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