What is retinal detachment?
Retinal detachment occurs when the two layers of the retina become separated from each other and from the wall of the eye. The retina detects light entering the eye and sends nerve signals to the brain about what the eye sees. If the retina detaches, it no longer works properly. This causes vision loss in the affected area of the retina. Vision loss from retinal detachment can range from very mild to severe and even to total blindness.
The most common type of detachment occurs when a tear or hole forms in the retina, allowing fluid from the middle of the eye to flow under the retina. This causes the layers of the retina to separate.
What causes retinal detachment?
Most retinal detachment begins when the vitreous gel, the thick fluid that fills the center of the eye, shrinks and separates from the retina. This is called posterior vitreous detachment (PVD), a common condition that is often harmless. Sometimes, though, PVD can tear the retina. At points where the vitreous gel is strongly attached to the retina, it can pull so hard on the retina—a process called traction—that it tears the retina. The tear allows fluid to collect under the retina and may cause the retina to detach.
An eye or head injury, nearsightedness (myopia), eye disease, and conditions such as diabetes can also lead to retinal detachment.
Retinal detachment can progress quickly. Because retinal detachment affects side (peripheral) vision first, you may not notice the vision loss right away. If not treated, detachment can spread to the center of the retina (macula) and damage central vision.
Retinal detachment requires urgent care. Without treatment, vision loss from retinal detachment can progress from minor to severe or total within a few hours or days.
Most cases of retinal detachment begin when the vitreous gel that fills the center of the eye shrinks and separates from the retina (called posterior vitreous detachment, or PVD). Symptoms of PVD include:
Floaters in your field of vision. Floaters are thick strands or clumps of solid vitreous gel that develop as the gel ages and breaks down. Floaters often appear as dark specks, globs, strings, or dots.
Flashes of light or sparks when you move your eyes or head. These are easier to see against a dark background. The brief flashes occur when the vitreous gel tugs on the retina (vitreous traction).
Only surgery can repair retinal detachment. It is usually successful and, in many cases, restores good vision.
The most common methods of repairing a retinal detachment are:
- Scleral buckling surgery. Your eye doctor (ophthalmologist) places a piece of silicone sponge, rubber, or semi-hard plastic on the outer layer of your eye and sews it in place. This relieves traction on the retina, preventing tears from getting worse, and holds the layers of the retina together.
- Pneumatic retinopexy. Your eye doctor injects a gas bubble into your eye. The bubble floats to the detached area and presses lightly against the tear, closing the tear and flattening the retina so that no fluid can build up under it. Your doctor then uses a freezing probe (cryopexy) or laser beam (photocoagulation) to seal the tear in the retina.
- Vitrectomy, or the removal of the vitreous gel from the eye. Vitrectomy gives the eye doctor better access to the retina to repair holes and close very large tears.
The most common methods of repairing a retinal tear are:
- Laser photocoagulation. Your eye doctor uses an intense beam of light that travels through the eye to make tiny burns around the tear in the retina. The burns form scar tissue, which seals the tear.
- Cryopexy (freezing). Your eye doctor uses a probe to freeze and seal the retina around the tear.
There is no medication to treat retinal detachment.