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Retinal Detachment

What is a Retinal Detachment?

A retinal detachment is a serious eye emergency causing acute, painless vision loss. The retina, the light-sensitive tissue lining the back of the eye, pulls away from its normal position. If not treated early, a retinal detachment can lead to permanent vision loss. It is more likely to develop in people who are nearsighted, have a family history of retinal detachments, or have sustained a serious eye injury.

Causes and Symptoms

Most retinal detachments are caused by one or more small tears or holes in the retina. As the vitreous (the gel-like substance in the eye) shrinks with age, it can pull on the retina and cause a tear. Fluid can then pass through the tear and lift the retina off the back of the eye.

Warning Signs:

  • A sudden increase in floaters (small dark spots or squiggly lines)
  • Flashes of light in one or both eyes
  • A wavy or watery quality in your vision
  • The appearance of a dark shadow or a "curtain" over a portion of your visual field

If you experience any of these symptoms, it is crucial to see an ophthalmologist immediately. Early treatment for a retinal tear can prevent a full detachment.

Diagnosis

An ophthalmologist can diagnose a retinal detachment or tear during a comprehensive eye exam where the pupils are dilated. This allows for a clear view of the retina at the back of the eye using an indirect ophthalmoscope.

Treatment

If the retina is torn but not yet detached, the tear can often be sealed with a laser (photocoagulation) or a freezing treatment (cryopexy) to prevent a detachment. Once the retina has detached, surgery is required to repair it.

Surgical Options:

  • Pneumatic Retinopexy: A gas bubble is injected into the eye to push the retina back into place.
  • Scleral Buckle: A silicone band is placed around the eye to gently push the eye wall against the retina, allowing the tear to heal.
  • Vitrectomy: The vitreous gel is removed and replaced, often with a gas bubble or silicone oil, to hold the retina in place.

With modern surgical techniques, over 90% of retinal detachments can be successfully reattached, though sometimes more than one operation is necessary. The degree of vision that returns depends on how long the retina was detached.