A detached retina happens when the retina peels away or detaches from its underlying layer of support tissue at the back of the eye. The retina is a thin layer of light-sensitive nerve cells. People need a healthy retina to be able to see clearly.
At first, detachment might only affect a small part of the retina. Without treatment, however, the whole retina can peel off, and a person risks losing the vision from that eye.
A detached retina, or retinal detachment, is a medical emergency.
Various factors increase the risk of a detached retina, including severe myopia, diabetes, previous eye surgery, and an injury that affects the eye.
In this article, read about the symptoms of a detached retina, why it happens, and the treatment options.
A person with a detached retina may experience the following symptoms:
- Photopsia, or sudden, brief flashes of light outside the central part of their vision, called peripheral vision, especially when the eye moves.
- A sudden increase in the number of floaters — debris in the eye that looks like strings of transparent bubbles or rods that follow the field of vision as the eyes turn.
- A shadow that appears in the peripheral vision and gradually spreads towards the center of the field of vision.
- A sensation that a transparent curtain is coming down over the field of vision.
A detached retina is not usually painful.
Retinal detachment happens when a part of the eye that is responsible for creating images pulls away from the back of the eye. It
The retina is the layer of tissue that lines the inside of the eye. It is light-sensitive and sends visual signals to the brain through the optic nerve. When the eye sees, light goes through the optical system of the eye and hits the retina. This produces an image that the retina translates into neural impulses that it sends to the brain through the optic nerve.
In other words, an image focuses on the retina, nerve cells process the information, and they send it by electrical impulses to the brain.
Damage to the retina can affect a person’s ability to see.
Retinal detachment happens when this layer pulls away from its usual position. Sometimes, small tears in the retina can cause detachment.
The macula is the part of the retina that is responsible for vision. In retinal detachment, the macula may or may not become detached. If it does, there is a higher chance of central vision loss.
Types of detached retina
Rhegmatogenous retinal detachment
This is a break, tear, or hole in the retina. This hole allows liquid to pass from the vitreous space into the space between the sensory retina and the retinal pigment epithelium. The pigment epithelium is the pigmented cell layer just outside the neurosensory retina.
Secondary retinal detachment
Also known as exudative or serous retinal detachment, this happens when fluid builds up under the retina due to inflammation, blood vessel problems, or injury. There is no hole, break, or tear.
Tractional retinal detachment
This is when an injury, inflammation, or the formation of new blood vessels causes the fibrovascular tissue to pull the sensory retina from the retinal pigment epithelium.
Surgery is often necessary to find any retinal breaks, seal them, and relieve traction, or pulling. Without surgery, there is a high risk of total vision loss.
Options for surgery
Scleral buckle surgery
In the area where the retina has detached, the surgeon will attach a tiny flexible band of silicone rubber or sponge onto the sclera, outside the white of the eye. The band pushes the sides of the eye toward the retina, which helps it attach.
They may use freezing, known as cryopexy, or laser therapy to carry out other repairs.
The doctor will use anesthetic to carry out this surgery and they will do the surgery in the operating room.
After the procedure, the person can expect:
- to feel some soreness in the eye
- to wear an eye patch for the first day or so
- to avoid activities such as heavy lifting until healing is complete
The doctor will check the eye’s progress in a follow-up appointment.
A surgeon may use this if the detachment is uncomplicated.
The doctor will:
- inject some fluid to numb the eye
- use a small needle to remove some fluid from the eye
- inject an air or gas bubble into the eye
- use laser or cryopexy to make any necessary repairs
The bubble will hold the retina in place as the layers start working together to remove the fluid. After some days, the pressure from the bubble will cause the retina to reattach to the wall of the back of the eye.
After surgery, the person can expect to:
- see the bubble in the side of their vision until it disappears
- hold their head in a particular way for some days to keep the bubble in place
- avoid flying and heavy lifting
The bubble will disappear over time.
This is similar to pneumatic retinopexy.
A surgeon will:
- numb the eye
- remove the vitreous gel from the eye
- insert a gas or silicone oil bubble to hold the retina in place
A gas bubble will disappear in time. If the surgeon uses silicone oil, they will remove it later in another procedure. It takes longer to perform than pneumatic retinopexy and will likely take place in a hospital rather than a doctor’s office.
How successful is surgery?
The National Eye Institute estimates that around
There is a small risk of complications after surgery. These are usually temporary but include:
The person’s vision should return 4–6 weeks after treatment, but if the macula becomes detached, the person’s sight may never be as clear as before.
Some people develop cataracts, as these can occur after any eye surgery.
Sometimes, it is not possible to reattach the retina, and the person’s vision will continue to deteriorate. If the detachment has been present for some time, the person is less likely to recover their vision. For this reason, it is best to seek treatment within
The outlook for a person with retinal detachment will depend on the reason for the detachment, the type of detachment, the extent of the damage, and whether or not the macula remains attached.
If the macula remains attached, some statistics suggest that
The cost of surgery for retinal detachment depends on the type of procedure and where the surgery takes place.
Attending regular eyesight tests can help to reduce the risk of retinal detachment, as eye exams can sometimes detect eye conditions such as detached retina in the early stages. It may also detect conditions that could lead to future retinal issues.
If a doctor suspects retinal detachment, they will usually refer the person to an eye specialist, or ophthalmologist, for a precise diagnosis.
The ophthalmologist will examine the eye after dilating, or widening, the pupils with eye drops.
Many factors can increase the risk of developing retinal detachment. They
- genetic factors, as retinal detachment can
sometimes occurin family clusters being male
- having severe nearsightedness
- previous eye surgery
- previous retinal detachment in the other eye
- trauma — for example, a blow to the eye
- diabetes, especially if it is hard to manage
- cancer that has spread to the eye
- infectious diseases such as tuberculosis, toxoplasmosis, and syphilis
- pre-eclampsia, which involves very high blood pressure and can occur during pregnancy
- having an organ transplant
- various eye conditions, such as retinopathy, lattice degeneration, and retinal vein occlusion
- structural features that affect the eye — for instance, enclosed ora bays
If a person has any of these risk factors, an ophthalmologist can help them understand if there is a risk of a retinal detachment.
A person can experience a detached retina if there is damage to the eye — for example, because of an injury or eye condition.
Warning signs include flashing lights in the eye, a sudden increase in floaters, and vision loss, often starting from the outside and moving inward. If these symptoms occur, the person should seek help as soon as possible because permanent vision loss can result if they do not get treatment.
Most people who experience retinal detachment will need surgery. A doctor will use precision instruments to make repairs and may insert a bubble to help the retina reattach.