Retinal Detachment
The retina is the
light-sensitive layer of tissue that lines the inside of the eye and sends
visual messages through the optic nerve to the brain. When the retina detaches,
it is lifted or pulled from its normal position. If not promptly treated,
retinal detachment can cause permanent vision loss.
In some cases there may be small areas of the retina that are torn. These areas,
called retinal tears or retinal breaks, can lead to retinal detachment.
Symptoms include a sudden
or gradual increase in either the number of floaters, which are little "cobwebs"
or specks that float about in your field of vision, and/or light flashes in the
eye. Another symptom is the appearance of a curtain over the field of vision. A
retinal detachment is a medical emergency. Anyone experiencing the symptoms of a
retinal detachment should see an eye care professional immediately.
There are three different types of retinal detachment:
Rhegmatogenous [reg-ma-TAH-jenous] -- A tear or break in the retina allows fluid
to get under the retina and separate it from the retinal pigment epithelium
(RPE), the pigmented cell layer that nourishes the retina. These types of
retinal detachments are the most common.
Tractional -- In this type of detachment, scar tissue on the retina's surface
contracts and causes the retina to separate from the RPE. This type of
detachment is less common.
Exudative -- Frequently caused by retinal diseases, including inflammatory
disorders and injury/trauma to the eye. In this type, fluid leaks into the area
underneath the retina, but there are no tears or breaks in the retina.
A retinal detachment can occur at any age, but it is more common in people over
age 40. It affects men more than women, and Whites more than African Americans.
A retinal detachment is also more likely to occur in people who:
Are extremely nearsighted
Have had a retinal detachment in the other eye
Have a family history of retinal detachment
Have had cataract surgery
Have other eye diseases or disorders, such as retinoschisis, uveitis,
degenerative myopia, or lattice degeneration
Have had an eye injury
Retinal detachments are treated with surgery that may require the patient to
stay in the hospital. In some cases a scleral buckle, a tiny synthetic band, is
attached to the outside of the eyeball to gently push the wall of the eye
against the detached retina. If necessary, a vitrectomy may also be performed.
During a vitrectomy, the doctor makes a tiny incision in the sclera (white of
the eye). Next, a small instrument is placed into the eye to remove the
vitreous, a gel-like substance that fills the center of the eye and helps the
eye maintain a round shape. Gas is often injected to into the eye to replace the
vitreous and reattach the retina; the gas pushes the retina back against the
wall of the eye. During the healing process, the eye makes fluid that gradually
replaces the gas and fills the eye. With all of these procedures, either laser
or cryopexy is used to "weld" the retina back in place.
With modern therapy, over 90 percent of those with a retinal detachment can be successfully treated, although sometimes a second treatment is needed. However, the visual outcome is not always predictable. The final visual result may not be known for up to several months following surgery. Even under the best of circumstances, and even after multiple attempts at repair, treatment sometimes fails and vision may eventually be lost. Visual results are best if the retinal detachment is repaired before the macula (the center region of the retina responsible for fine, detailed vision) detaches. That is why it is important to contact an eye care professional immediately if you see a sudden or gradual increase in the number of floaters and/or light flashes, or a dark curtain over the field of vision.