What is Retinal Detachment?
Your retina is the thin sensory membrane that lines the inner surface of the back of your eyeball. It consists of several layers of cells, one of which contains specialized cells called photoreceptors. The human eye is equipped with two types of photoreceptors: rods and cones.
When the retina becomes detached from the underlying supportive tissue, a condition called retinal detachment, it can put you at risk for serious sight loss. Retinal detachment can occur suddenly if the retina detaches immediately, but it can also occur slowly over time as the retina pulls away from the supportive tissue. This slowly progressing condition is called a retinal tear. A retinal tear, if left untreated, can progress to retinal detachment.
If your retina is not reattached quickly the damage may be permanent.
Symptoms to Consider
There are a variety of symptoms that individuals with retinal detachment or retinal tear may experience. These include:
- Loss of vision
- Spots in your vision
- Blurry vision
- A shadow or curtain descending over your vision, either from the top of your eye or from the side
There is no pain associated with retinal detachment or retinal tearing, but that does not mean that both conditions are not serious.
What Causes (or Potentially Causes) Retinal Detachment?
- Trauma: A facial or eye injury can cause your retina to become detached. If you experience any trauma to your eyes or face you should monitor your vision carefully and look for signs of a retinal tear or retinal detachment.
- Nearsightedness: Individuals who are extremely nearsighted are also at an increased risk for retinal detachment since their eyeballs are naturally quite long, which puts strain on the retina and the supportive tissue.
- Eye Surgery: In some rare cases LASIK surgery or cataract surgery can inadvertently cause your retina to become detached, especially if you are already extremely nearsighted.
- Diseases and Disorders: Eye diseases or tumors in your eye may also cause retinal detachment. Other conditions, such as diabetes and sickle cell disease, also put you at an increased risk for retinal detachment. Diabetic retinopathy, which causes new blood vessels to grow under your retina, may also push your retina away from the supportive tissue, causing retinal tearing or retinal detachment. Individuals with retinoschisis, uveitis, degenerative myopia, or lattice degeneration are also at an increased risk of retinal tearing or detachment.
- Your Personal and Family History: Individuals who have a family history of retinal tearing or detachment may also be at an increased risk of retinal tearing or detachment. You are also more likely to be at risk for retinal tearing or detachment if your other eye has experienced either of these conditions.
Fluid movement within the eye can also, in rare cases, cause retinal detachment.
Who is Prone to Retinal Detachment?
According to the National Eye Institute individuals over the age of forty are more likely to experience retinal detachments or retinal tears. Men, as well as Caucasian individuals, are also more likely to experience retinal detachment then women or African Americans.
What Happens if You Have Retinal Detachment
There is no pain associated with retinal tears or retinal detachment, but that doesn’t mean that these conditions are not serious. If you think you might be experiencing a retinal tear or retinal detachment you should contact your optometrist immediately.
There are a variety of treatments available for detached retinas, but all of these treatments require surgery. These procedures are typically performed by retinal specialists, such as an ophthalmologist who has advanced training in the surgical and medical treatment of retinal disorders.
Typically the sooner your retina is reattached the better your chances of regaining all of your vision.
A scleral buckle is the most common type of retinal detachment surgery and consists of affixing a small band of silicon or plastic around the sclera (the outside of your eye) like a belt. This band then compresses (or buckles) the eye inwards, reducing the amount of strain on your retina. This, in turn, allows the retina to reattach to the supportive tissue. The scleral buckle is attached to your eye’s posterior and is left in place after surgery. A scleral buckle is invisible and painless, and this procedure is often combined with either a pneumatic retinopexy or vitrectomy so that the underlying supporting tissue (also called the retinal pigment epithelium, or RPE) can be effectively fused to your retina.
During a pneumatic retinopexy, your surgeon will inject a small bubble of gas into the vitreous fluid in your eye. This bubble will then push the detached portion of your retina back onto the supporting tissue
During a vitrectomy, your surgeon will remove some of the vitreous fluid from the inside of your eye and replace it with a clear silicone oil. This silicone oil will then push the detached portion of your retina back into place and hold it there while it heals.
If your retinal detachment was caused by a retinal tear your surgeon may also use either a laser or a freezing tube to firmly reattach your retina to the supporting tissues and seal the tear. If a laser is used this procedure is called laser photocoagulation, and if a freezing probe is used the procedure is called cryopexy.
The odds of successfully reattaching your retina depend a lot on a lot of factors including the location, cause, and extent of the retinal tear. A successful retinal reattachment also does not guarantee that your vision will return to normal. Typically, visual outcomes are better if the retinal detachment is limited to the periphery of your retina, and does not affect the macula (the central portion of your retina).