Retinal Detachment

Normal retina. UHB Trust

Lining the inside of the eyeball is a light-sensitive layer of neural cells called the retina. Much like a camera, the retina captures light rays and turns them into electrical impulses. These impulses travel along the optic nerve to the brain, where they are converted into pictures. The retina lies on top of the choroid, a tissue responsible for nourishing the retina. Retinal detachment occurs when the retina separates from the choroid.

Retinal detachment is a true eye emergency and requires immediate treatment to avoid severe vision loss and potential blindness.

Types of Retinal Detachment:

There are three types of retinal detachment:

  • Rhegmatogenous retinal detachment is the most common type. It is caused by tears or holes in the retina, referred to as retinal breaks.
  • Tractional retinal detachment occurs when scar tissue or other abnormal tissue grows on the surface of the retina, pulling the retina away from the layer beneath it.
  • Exudative retinal detachment occurs when fluid or blood flows under the retina, separating the it from the layer beneath. Exudative retinal detachment is most often a complication of other conditions including, macular degeneration, eye tumors and high blood pressure.

Causes:

Retinal detachment is often caused by trauma. It is more common in nearsighted people, who have a slightly longer eyeball.

Some retinal detachments occur spontaneously with no specific cause. These are often related to changes in the vitreous, the gel-like fluid that fills the cavity of the eye. As we age, the vitreous can liquefy and separate from the retina, causing a posterior vitreal detachment (PVD). Certain diseases can also cause retinal detachment by allowing new blood vessel growth and scarring, which cause contractions in the retina.

Risk Factors:

  • Advancing age-related changes in the vitreous
  • High level of nearsightedness
  • Weak areas in the periphery of the retina
  • A family history of retinal detachment
  • Previous retinal detachment in one eye
  • History of eye surgery, such as cataract surgery
  • Eye trauma

Symptoms:

There is no pain when the retina detaches. However, there are several common visual symptoms that should alert you to a potential retinal detachment:

  • Floaters that may appear as grey spots, strings or spider webs floating in your field of vision
  • Flashes of light
  • A dark curtain or veil moving over your vision
  • Blurry vision

If you experience any of these symptoms, do not hesitate to seek medical attention. Time is of the essence in the treatment of a retinal detachment. Early treatment can improve the chance of restoring your vision.

Diagnosis:

The diagnosis of a retinal detachment is made by an eye care professional. An optometrist or ophthalmologist may dilate your pupils and use a binocular indirect ophthalmoscope to examine the inside of the eye with a three-dimensional view.

Occasionally, an ultrasound device may be used if there is dense bleeding inside the eye. Blood may sometimes obstruct the view, making it difficult to clearly see the retina. The ultrasound device produces sound waves that bounce off the back of the eye, forming a picture that allows the doctor to see if the retina is truly detached.

Treatment:

There are several ways to treat a retinal detachment. Treatment depends on the type, severity, and location of the detachment.

  • Pneumatic retinopexy is used when the detachment occurs in the upper part of the eye. The eye is injected with a gas bubble that presses against the retina.
  • Cryotherapy uses a freezing method or laser to tack the retina back into place.
  • Lasers are used to create small scars in the eye to prevent further tearing or detachment.
  • A scleral buckle is a small band of silicone that is attached to the outside of the eye to hold the retina in place. The buckle is not visible from the outside.

Continue Reading