Description

Retinal detachment occurs when the thin layer of tissue at the back of the eye away from its normal position. This layer of tissue called the retina. Retinal detachment is an emergency.

The retinal detachment separates the retinal cells from the layer of blood vessels that provides oxygen and nutrients to the eyes. No retinal detachment goes untreated, the greater is the risk of permanent loss of vision in the affected eye.

The symptoms of retinal detachment may include the following: reduction of the vision, the sudden appearance of the dark floating shapes and flashes of light in your vision, and loss of side vision. Get in touch with an eye doctor called an ophthalmologist, immediately can help save your vision.

Symptoms

The retinal detachment is painless. Often, the symptoms are present before a retinal detachment occurs before or it has gotten worse. You may notice symptoms such as:

  • The sudden appearance of small spots, or wavy lines that seem to drift through your field of vision. These are called floaters.
  • Flashes of light in one or both eyes. These are the so-called photopsias.
  • Blurred vision.
  • The side vision, also called peripheral vision, which becomes worse.
  • A curtainlike shade over your field of vision.

When to see a doctor

Consult a health care professional right away if you have any of the symptoms of retinal detachment. This condition is a medical emergency that can cause long-lasting loss of vision.

Causes

There are three main types of retinal detachment, and their causes are varied:

  • Rhegmatogenous (reg-mu-TOJ-uh-nus).This type of retinal detachment is the most common. A detachment rhegmatogenous is caused by a hole or tear in the retina that allows fluid to pass through and collect under the retina. This fluid builds up and causes the retina to pull away from the underlying tissues. The areas where the retina detaches lose their blood supply and stop working. This causes the loss of vision. The most common cause of rhegmatogenous detachment of aging. As the age, the gel-like material that fills the inside of the eye, called the vitreous (VIT-ree-us), you can change in texture and reduce or make more liquid. Usually, the vitreous separates from the surface of the retina, without any type of complications. This is a common condition that is called a posterior vitreous detachment (PVD). When the vitreous separates or detaches the retina, you can pull the retina with enough force to create a tear. Most of the times not. But if aPVDcauses a tear and the tear is not treated, the liquid vitreous can pass through the tear in the space behind the retina. This causes the detachment of the retina.
  • Tractional. This type of detachment can happen when the scar tissue that grows on the surface of the retina. The scar tissue causes the retina to pull away from the back of the eye. Detachment, tractional is usually seen in people who have poorly controlled diabetes.
  • Exudative. In this type of detachment, fluid builds up under the retina, but no holes or tears in the retina. Exudative detachment can be caused by macular degeneration, infection, tumors, or inflammatory diseases.

Rhegmatogenous (reg-mu-TOJ-uh-nus). This type of retinal detachment is the most common. A detachment rhegmatogenous is caused by a hole or tear in the retina that allows fluid to pass through and collect under the retina. This fluid builds up and causes the retina to pull away from the underlying tissues. The areas where the retina detaches lose their blood supply and stop working. This causes the loss of vision.

The most common cause of rhegmatogenous detachment of aging. As the age, the gel-like material that fills the inside of the eye, called the vitreous (VIT-ree-us), you can change in texture and reduce or make more liquid. Usually, the vitreous separates from the surface of the retina, without any type of complications. This is a common condition that is called a posterior vitreous detachment (PVD).

When the vitreous separates or detaches the retina, you can pull the retina with enough force to create a tear. Most of the times not. But if a PVD causes a tear and the tear is not treated, the liquid vitreous can pass through the tear in the space behind the retina. This causes the detachment of the retina.

Risk factors

The following factors increase the risk of retinal detachment:

  • Aging — retinal detachment is more common in people between the ages of 40 to 70.
  • Past the retinal detachment in one eye.
  • The family history of retinal detachment.
  • Extreme nearsightedness, also called myopia.
  • Past eye surgery, such as cataract removal.
  • Past severe eye injury.
  • The history of other eye disease or condition, including retinoschisis, uveitis or thinning of the peripheral retina called degeneration lattice.

Diagnosis

The diagnosis consists of the steps that your health professional needs to find out if the retinal detachment is the cause of your symptoms. Your health care team may use the following tests and instruments to diagnose retinal detachment:

  • Examination of the retina. Your health care professional may use an instrument with a bright light and special lenses to check the back of the eye, including the retina. This type of device provides a detailed view of the entire eye. Allows your healthcare professional to see any retinal holes, tears or detachments.
  • The ultrasound images. Your healthcare provider may use this test if bleeding has occurred in your eye. The bleeding makes it difficult to see the retina.

Your health professional likely to check both eyes, even if you have symptoms in one. If a retinal tear is not found at this visit, your health care professional may ask you to return within a couple of weeks. The visit is to confirm that the eye has not developed a delay in the tearing of the retina due to the same vitreous detachment. Also, if you have new symptoms, it is important to return to your health care professional immediately.

Treatment

The surgery is almost always the type of treatment used to repair a retinal tear, hole or detachment. Various techniques are available. Ask your eye doctor about the risks and benefits of treatment options. Together you can decide which treatment or combination of treatments is best for you.

Retinal tears

When the retina has a tear or hole, but still has not detached, your surgeon may suggest one of the following treatments. These treatments can help to prevent the detachment of the retina and preserve vision.

  • The laser surgery, also called photocoagulation or laser retinopexy. The surgeon directs a laser beam into the eye through the pupil. The laser makes the burns around the retinal tear to create scars that usually "weld" the retina to the underlying tissue.
  • Freezing, also called cryopexy. Before you start the treatment, give you a medication to numb the eye. Then, the surgeon applies a freezing probe to the outer surface of the eye, directly through the tear. Freezing causes a scar that helps protect the retina to the eye wall.

Both of these treatments can be performed in the office. More often, you may go home after the procedure. What is more likely is that it tells you not to do activities that can jar the eyes — such as running — for a couple of weeks or so.

Retinal detachment

If the retina has been detached, you will need surgery to repair it. It is ideal to get the surgery within days of finding out that your retina has detached. The type of surgery that your surgeon recommends depends on such factors as the location of the retinal detachment and how severe it is.

  • The injection of air or gas in the eye.This surgery is called pneumatic retinopexy (RET-ih-no-pek-see). A surgeon injects a bubble of air or gas in the central part of the eye, also called the vitreous cavity. When placed correctly, the bubble pushes the area of the retina that contains the or the holes of the wall of the eye. This stops the flow of fluid into the space behind the retina. The surgeon also uses cryopexy or laser photocoagulation for the treatment to create scars around the retinal break. The fluid that had collected under the retina is absorbed by the same, and the retina can then adhere to the wall of the eye. You may need to hold your head in a certain position for up to a week to keep the bubble in the correct position. The bubble goes away on its own in time.
  • The indentation of the surface of the eye. This surgery is called a scleral (SKLAIR-ul) buckling. This involves the surgeon sewing up a piece of silicone in the white part of the eye, called the sclera, on the affected area. This surgery scripts of the wall of the eye and releases a part of the force caused by the vitreous pulling on the retina. The silicone is placed in a way that does not obstruct your vision, and usually remains in place for life. During the surgery, cryoretinopexy, or laser photocoagulation can do to help to seal tears in the retina. If fluid has collected under the retina, the surgeon can drain.
  • Draining and replacing the fluid in the eye.This surgery is known as vitrectomy (hiv-TREK-tuh-me). The surgeon removes the vitreous humor, along with any tissue that is pulling on the retina. Air, gas or silicone oil is then injected into the vitreous space to help flatten the retina. During the surgery, tears in the retina can be sealed with cryoretinopexy or laser photocoagulation. There may be fluid under the retina that must be drained. The air or gas is injected into the vitreous area is absorbed at the time. The vitreous space of refills of liquid. If the silicone oil is used, it can be removed with surgery months later. Vitrectomy can be combined with scleral buckling.

The injection of air or gas in the eye. This surgery is called pneumatic retinopexy (RET-ih-no-pek-see). A surgeon injects a bubble of air or gas in the central part of the eye, also called the vitreous cavity. When placed correctly, the bubble pushes the area of the retina that contains the or the holes of the wall of the eye. This stops the flow of fluid into the space behind the retina. The surgeon also uses cryopexy or laser photocoagulation for the treatment to create scars around the retinal break.

The fluid that had collected under the retina is absorbed by the same, and the retina can then adhere to the wall of the eye. You may need to hold your head in a certain position for up to a week to keep the bubble in the correct position. The bubble goes away on its own in time.

Draining and replacing the fluid in the eye. This surgery is known as vitrectomy (hiv-TREK-tuh-me). The surgeon removes the vitreous humor, along with any tissue that is pulling on the retina. Air, gas or silicone oil is then injected into the vitreous space to help flatten the retina. During the surgery, tears in the retina can be sealed with cryoretinopexy or laser photocoagulation. There may be fluid under the retina that must be drained.

The air or gas is injected into the vitreous area is absorbed at the time. The vitreous space of refills of liquid. If the silicone oil is used, it can be removed with surgery months later.

Vitrectomy can be combined with scleral buckling.

After the surgery, your vision may take months to get better. You may need a second surgery for the success of the treatment. Some people never get back to all of your vision loss.

Coping and support

The detachment of the retina can cause vision loss. Depending on your quantity of the loss of vision, your lifestyle can change a lot.

You can find the following ideas helpful as you learn to live with impaired vision:

  • Get the glasses. Your prescription glasses can be changed after the repair of the retinal detachment, especially if the detachment is treated with a scleral buckle. To obtain an updated version of the prescription once your eye has healed to make the most of your vision. Application of safety glasses to protect your eyes.
  • Brighten up your home. Have appropriated the light in your home for reading and other activities.
  • Make your home safer. Get rid of carpeting or to protect the rugs to the floor with masking tape to prevent slips and falls. Move the power cables out of the way of the areas where walks a lot. And place colored tape on the edges of the stairs. Think about the installation of lights that turn on when they detect movement.
  • Ask for help if you need it. Tell your friends and family members about the changes in the vision, so that they can help you.
  • Get help from the technology. Audiobooks and computer screen readers can help with the reading. Another new technology continues to advance.
  • Explore driving services. Search in trucks and buses, volunteer management networks, or ride-sharing services available in your area for people with vision problems.
  • Talk with other people with vision problems. Take advantage of the networks, support groups and resources for people with vision problems.

Preparing for your appointment

Here's some information to help you prepare for your appointment.

What you can do

  • Be aware of the restrictions prior to your appointment. At the time of making the appointment, ask if you need to do anything in advance.
  • List of the symptoms you have, including those that do not seem to be related to the reason why you made the appointment.
  • The list of personal information, including major stresses and recent changes in life.
  • List of all the medicines, vitamins, and supplements you are taking, including dosage.
  • Ask a family member or friend to come with you. You may want to ask someone that could drive home if your eyes are dilated as part of its review. Or this person could write the information of your health care team during the appointment.
  • List of questions to ask your health care professional.

For the detachment of the retina, some basic questions include:

  • What is the most likely cause of my symptoms?
  • What are other possible causes of the symptoms?
  • What tests do I need? I need to do something to prepare for them?
  • Is my condition likely to be short-term or ongoing?
  • What are my treatment options, and I recommend?
  • There are options apart from the main treatment that I have suggested?
  • I have another medical condition. How can I better manage my conditions?
  • Do I need to limit my activities in any way?
  • I need to see a specialist?
  • Do you have any brochures or other printed material that I can take with me? What sites do you recommend?
  • What is going to determine whether I should plan for a follow-up visit?
  • If I need surgery, how long is recovery?
  • I'm going to be able to travel after the surgery? It will be safe to travel by plane?

What to expect from your doctor

Your healthcare provider will likely ask questions such as:

  • When did you first start having symptoms?
  • Do you have symptoms all the time, or come and go?
  • How severe are the symptoms?
  • Has had none of the symptoms in the other eye?
  • Have you ever had an eye injury?
  • Have you ever had swelling of the eyes?
  • Have you ever had eye surgery?
  • Do you have other health conditions, such as diabetes?
  • Have any of your family members has had a retinal detachment?
Symptoms and treatment of Retinal detachment