Retina

Retinal Tear & Detachment

Overview

As light rays enter the eye through the clear cornea, pupil and lens, they are focused directly onto the retina, the light-sensitive tissue lining the back of the eye. The retina converts light rays into impulses, sent through the optic nerve to your brain, where they are recognized as images.

A retinal detachment occurs when the retina is pulled away from its normal position. The retina does not work when it is detached, and vision becomes blurred. A retinal detachment is a very serious problem that almost always causes blindness unless it is treated.

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Retinal detachment

Causes

The vitreous is a clear gel that fills the middle of the eye. As we get older, the vitreous may pull away from its attachment to the retina at the back of the eye. Usually, the vitreous separates from the retina without causing problems, but sometimes the vitreous pulls hard enough to tear the retina in one or more places. Fluid may pass through the retinal tear, lifting the retina off the back of the eye, like wallpaper peeling off a wall. This process is called retinal detachment.

Risk Factors

The following conditions increase your chances of retinal detachment:

  • Nearsightedness

  • Previous cataract surgery

  • Severe injury

  • Previous retinal detachment in your other eye

  • Family history of retinal detachment

  • Weak areas in your retina that can be seen by your ophthalmologist

Symptoms

These early symptoms may indicate the presence of a retinal detachment:

  • Flashing lights

  • New floaters

  • A gray curtain moving across your field of vision

 

These symptoms do not always mean a retinal detachment is present; however, you should see your ophthalmologist as soon as possible. Your ophthalmologist can diagnose retinal detachment during an eye examination which will include pupil dilation. Sometimes, retinal tears or detachments are found during routine eye examinations.

Treatment
Retinal Tears

Most retinal tears need to be treated with laser surgery or cryotherapy (freezing), which seals the retina to the back wall of the eye. These treatments cause little or no discomfort and may be performed in your ophthalmologist's office. Treatment usually prevents retinal detachment.

 

Retinal Detachments

Almost all patients with retinal detachments require surgery to put the retina back in its proper position.

There are several ways to fix a retinal detachment with surgery. The characteristics of your detachment may determine the type of surgery. Your ophthalmologist should discuss the pros and cons of each procedure.

  • Scleral buckle

  • Pneumatic retinopexy

  • Vitrectomy

 

Any surgery has risks. However, an untreated retinal detachment usually results in permanent vision loss or blindness. Some of the surgical risks include:

  • Infection

  • Bleeding

  • High pressure in the eye

  • Cataract

 

Most retinal detachment surgery is successful, although a second operation is sometimes necessary.

Your vision may take many months to improve and in some cases may never return fully. The more severe the detachment, the less the vision may return.

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