What is retinal detachment?

The retina is a thin nerve membrane in the back of your eye. It detects light entering the eye. Then it sends signals to your brain about what the eye sees.

Retinal detachment means the retina has separated from the wall of the eye. This can lead to severe vision loss or blindness.

Surgery can reattach your retina. The sooner it's done, the better chance you'll be able to see well again.

Many people see floaters and flashes of light before they have symptoms of retinal detachment. Floaters and flashes don't always mean that you will have a retinal detachment. But they may be a warning sign, so it's best to be checked by a doctor right away.

Surgery is the only way to reattach the retina. There are many ways to do the surgery. They include using lasers, air bubbles, or a freezing probe to seal a tear in the retina and reattach the retina. This condition needs treatment right away. Without treatment, vision loss can become severe.

To diagnose retinal detachment, your doctor will ask you questions about your symptoms. You will be asked about your past eye problems and risk factors. The doctor will also test your near and distance vision (visual acuity) and side (peripheral) vision. These routine vision tests don't find retinal detachment itself. But they can find problems that could lead to or result from retinal detachment.

A doctor can usually see a retinal tear or detachment while checking the retina using ophthalmoscopy. This test allows the doctor to see inside the back of the eye using a magnifying tool with a light.

If a retinal tear or detachment involves blood vessels in the retina, you may have bleeding in the middle of the eye. In these cases, your doctor can view the retina using ultrasound or optical coherence tomography. These are tests that use sound or light waves to see the retina.

Follow any instructions from your doctor. You may need to rest and sleep with your head in a certain position. You may also need to wear an eye patch or use eyedrops. Ask your doctor if it's okay to travel by plane.

Surgery is the only treatment for retinal detachment. Without treatment, vision loss can progress from minor to severe or even to blindness. This can happen within a few hours or days.

How soon you need surgery usually depends on whether the retinal detachment has or could spread far enough to affect central vision. The macula is the part of the retina that provides central vision. If it loses contact with the layer beneath it, it quickly loses its ability to process what the eye sees.

• Having surgery while the macula is still attached will usually save vision.
• If the macula is detached, surgery may occur a few days later. Good vision after surgery is still possible. But it's less likely.

There are several types of surgery. The type you have depends on the cause and type of detachment you have, and any other eye problems. These are three of the most common types.

Pneumatic retinopexy.

The doctor injects a gas bubble into the middle of the eyeball. The gas bubble floats to the detached area and lightly presses the detached retina to the wall of the eye. The eye doctor then uses a freezing probe (cryopexy) or laser beam (photocoagulation) to seal the tear.

Scleral buckling surgery.

The doctor places a piece of silicone sponge, rubber, or semi-hard plastic on the outer layer of your eye and sews it in place. This relieves pulling (traction) on the retina. It gently presses the wall of the eye to the retina, so that the retina will reattach. It also helps prevent a retinal tear from getting worse.

Vitrectomy.

The doctor removes the vitreous gel from the eye. This gives the doctor better access to the retina and other tissues. It allows the doctor to remove scar tissue from the retina, repair holes and tears, and push the retina back onto the wall of the eye so that it reattaches.

If scar tissue from the first surgery grows over the surface of your retina, you may need more than one surgery.

Things that may make surgery harder include:

• Glaucoma.
• Pupils that won't get larger (dilate).
• Infection inside or outside the eye.
• Scarring from previous surgery.
• Bleeding (hemorrhage) in the vitreous gel.
• Scars on or cloudiness in the cornea.
• Clouding of the lens. (This is called a cataract.)

Retinal detachment is caused by:

• Tears or holes in the retina. A tear in the retina is the most common cause of retinal detachment. These tears can happen when fluids collect under the retina. Tears can also be caused by posterior vitreous detachment (PVD), when the vitreous gel shrinks and separates from the retina. An eye or head injury or other eye disorders may also cause these tears or holes.
• Traction on the retina. If tissue builds up between the vitreous gel and the retina, it can pull the retina away from the back of the eye. The pulling is called traction.
• Fluid buildup under the retina. This fluid buildup can cause the retina to come off the back of the eye. Fluid buildup may be caused by inflammation or disease in the retina, in the layer just beneath the retina (choroid), in blood vessels, or in tissues in the eye.