Retinal Detachment

Definition: Retinal detachment is a condition that occurs when the retina separates from the supporting structures in the back portion of the eye.

Cause:  Retinal detachment usually occurs because one or more small holes have formed in the retina.  The fluid in the eye can then enter this hole, and like wallpaper peeling off a wall, become detached from the back wall of the eye.  Holes in the retina can form with trauma, degenerations in the edge of the retina or may occur after eye surgery.

Symptoms: The sudden onset of many new floaters or flashes of light may indicate a retinal tear has occurred.  Bleeding from the tear can cause floaters, and tugging on the retina by the vitreous jelly that fills the back of the eye can cause flashes.  If the retina begins to detach, the patient may say a fuzzy, oily smudge in the far edge of the vision that may slowly progress toward the center of vision.  If the retina responsible for the center of vision, the macula, becomes detached, the vision will decrease dramatically.  People experiencing these symptoms should be evaluated by an eye doctor as soon as possible.

Treatment:  Small tears in the retina that have not progressed to a retinal detachment can usually be treated with laser and observed closely.  If a retinal detachment has occurred, surgery in the operating room is usually needed.  A silicone band, called a scleral buckle, may be placed around the eye behind the eyelids to help the retina reattach.  A vitrectomy, or surgical removal of the vitreous gel may also be needed to help repair the retina.

Prognosis:  If a retinal detachment involves only the peripheral retina, then surgical repair usually helps maintain excellent vision.  If the detachment has progressed to involve the center of vision, the macula, then some vision may be lost, even after surgical reattachment of the retina.