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    Retinal detachment

    Retinal detachment is a separation of the light-sensitive membrane (retina) in the back of the eye from its supporting layers.

    Causes

    The retina is the clear tissue in the back of the eye. It helps you see the images that are focused on it by the cornea and the lens.

    • The most common type of retinal detachments are often due to a tear or hole in the retina. Eye fluid may leak through this opening. This causes the retina to separate from the underlying tissues, much like a bubble under wallpaper. This is most often caused by a condition called posterior vitreous detachment.It canalso be caused by trauma and very bad nearsightedness. A family history of retinal detachment also increases your risk.
    • Another type of retinal detachment is called tractional detachment. Thistype occursin people who have uncontrolled diabetes, had retinal surgery before, or have chronic inflammation.

    When the retina becomes detached, bleeding fromnearby blood vesselscan cloud the inside of the eye so that you may not see clearly or at all. Central vision becomes severely affected if the maculabecomes detached. The macula isthe part of the retina responsible for sharp, detailed vision.

    Symptoms

    Symptoms of detached retina can include:

    • Bright flashes of light, especially in peripheral vision
    • Blurred vision
    • Floaters in the eye
    • Shadow or blindness in a part of the visual field of one eye

    Exams and Tests

    The ophthalmologist (eye doctor) will examine your eyes. Tests will be done to check the retina and pupil:

    • Using special dye and camera to look at blood flow in the retina (fluorescein angiography)
    • Checking pressure inside the eye (tonometry)
    • Examining the back part of the eye, including the retina (ophthalmoscopy)
    • Checking eyeglass prescription (refraction test)
    • Checking color vision
    • Checking the smallerst letters that can be read (visual acuity)
    • Checking structures at the front of the eye (slit-lamp examination)
    • Ultrasound of the eye

    Treatment

    Most people with a retinal detachment need surgery. Surgery may be doneright awayor after a short time.

    Surgery may not be needed if you do not have symptoms or have had the detachment for a while.

    Some types of surgery can be done in your doctor's office.

    • Lasers may be used to seal tears or holes in the retina before a retinal detachment occurs.
    • If you have a small detachment, the doctor may place a gas bubble in the eye. This is called pneumatic retinopexy. It helps the retina float back into place. The hole is sealed with a laser.

    Severe detachments require surgery in a hospital.These procedures include:

    • Scleral buckle to gently push the eye wall up against the retina
    • Vitrectomy to remove gel or scar tissue pulling on the retina, used for the largest tears and detachments.

    Tractional retinal detachments may be watched for a while before surgery. If surgery is needed, a vitrectomy is usually done.

    Outlook (Prognosis)

    How well you do after a retinal detachment depends on the location and extent of the detachment and early treatment. If the macula was not damaged, the outlook with treatment can be excellent.

    Successful repair of the retina does not always fully restore vision.

    Some detachments can not be repaired.

    A retinal detachment causes loss of vision. Surgery to repair it may help restore some or all of your vision.

    When to Contact a Medical Professional

    A retinal detachment is an urgent problem that requires medical attention within 24 hours of the first symptoms of new flashes of light and/or floaters.

    Prevention

    Use protective eye wear to prevent eye trauma. Control your blood sugar carefully if you have diabetes. See your eye care specialist once a year. You may need more frequent visits if you have risk factors for retinal detachment. Be alert to symptoms of new flashes of light and/or floaters.

    References

    American Academy of Ophthalmology Retina Panel. Preferred Practice Pattern Guidelines. Posterior vitreous detachment, retinal breaks, and lattic degeneration. San Francisco, Ca: American Academy of Ophthalmology; 2013. Accessed August 29, 2013.

    Connolly BP, Regillo CD. Rhegmatogenous retinal detachment. In: Tasman W, Jaeger EA, eds. Duane’s Ophthalmology on DVD-ROM - 2013 Edition. Philadelphia, Pa: Lippincott Williams & Wilkins; 2013: vol 3, chap 27.

    Wolfe JD, Williams GA. Techniques of scleral buckling. In: Tasman W, Jaeger EA, eds. Duane’s Ophthalmology on DVD-ROM - 2013 Edition. Philadelphia, Pa: Lippincott Williams & Wilkins; 2013: vol 6, chap 59.

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      A Closer Look

        Self Care

          Tests for Retinal detachment

            Review Date: 8/24/2013

            Reviewed By: Franklin W. Lusby, MD, Ophthalmologist, Lusby Vision Institute, La Jolla, California. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.

            The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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