Retinal Detachment
A retinal detachment is a critical eye emergency. Anyone experiencing retinal detachment symptoms should see an eye care professional immediately.
A Retinal Detachment or Tear (a rent or rip) occurs when the retina is separated (lifted or pulled away from its normal position) from its connection to the back of the eye. Tears often occur when the vitreous (gel that fills most of the inside of the eye between the retina and the lens) pulls loose or separates from its attachment to the retina. This is most likely to occur at the outside edges of the eye. Bleeding or hemorrhage may occur when a blood vessel is also torn. Small retinal tears or breaks may lead to detachment. Types of retinal detachment:
Rhegmatogenous (most common) a tear or break in the retina causes it to separate from the retinal pigment epithelium (RPE), the pigmented cell layer that nourishes the retina, and fill with fluid.
Tractional - scar tissue on the retina's surface contracts and causes it to separate from the RPE. Common with diabetics.
Exudative -- Frequently caused by retinal diseases, including inflammatory disorders and injury/trauma to the eye. In this type, fluid leaks into the area underneath the retina (subretina).
Signs, Symptoms, Functional Problems
Light flashes
“Wavy” or “watery vision
Veil or curtain obstructing vision or darkening of the peripheral visual field.
Shower of floaters that resemble spots, bugs, or spider webs
A sudden decrease of vision
Treatment
Permanent vision loss may occur if a detachment is not repaired within 24 to 72 hours.
Laser (thermal) or freezing (cryopexy) - to treat tear to prevent their progression to a full-scale detachment.
Pneumatic retinopexy - tear is small and easy to close. A small gas bubble is injected into the vitreous where it then rises and presses against the retina, closing the tear.
Vitrectomy - large tears - the vitreous is removed from the eye and replaced with a saline solution.
Scleral buckle - placing a silicone band or buckle around the eye to hold the retina in place. The band remains permanently attached and is not visible and remains permanently attached.
Silicone oil - In rare cases the vitreous gel is removed and replaced with silicone oil, which presses the retina into place. While the oil is inside the eye, the vision is extremely poor.
Who's at Risk for Retinal Detachment?
Nearsighted adults
People who have had an eye injury or post-cataract extraction surgery
People with a family history of retinal detachment
Detachment may also be spontaneous. This occurs more often in the elderly or in very nearsighted people.
Fact sheet developed by Sharon Grissom
Resources
Goldberg, Stephen, MD, & Trattler, William, MD (2005). Retinal Disease, Ophthalmology made ridiculously simple (3rd ed.)(Pp 6, 36, 59). Miami: MedMaster, Inc.
Cassin, Barbara (2006). Dictionary of eye terminology (5th ed.) (Melvin L. Rubin, MD, Ed.) (P 227). Gainesville, FL: Triad Publishing Co.
- Emedicine from Web MD
Eye Web.org
Health Newsflash.
National Eye Institute
Mayo Clinic.com
The Retina Source.com