Retinal detachment: causes, types and treatments

What is retinal detachment?

The retina is a delicate layer of cells at the back of the eye that captures light and sends visual information to the brain. Retinal detachment occurs when the retina separates from the eye wall, similar to wallpaper peeling off a wall. If untreated, it can lead to permanent vision loss or blindness due to the interruption of blood and oxygen supply.

Retinal detachment surgery is often required to reattach the retina once detachment occurs.

Is retinal detachment an emergency?

Yes, retinal detachment often requires urgent treatment. If you experience new symptoms of peripheral visual loss that have not yet affected central vision (referred to as macula-on or macula-sparing retinal detachment), emergency same-day surgery may be necessary.

Who is at risk of retinal detachment?

Retinal detachment affects about 1 in 10,000 people per year in the general adult population. Risk factors include:

• Age over 50 years
• Significant short-sightedness
• Severe eye trauma
• Previous eye surgery
• Family history of retinal detachment

Causes and types of retinal detachment

There are three main types of retinal detachment:

1. Rhegmatogenous retinal detachment

• Causes: Retinal tears or holes due to posterior vitreous detachment, eye injury, or significant short-sightedness.
• Description: This type involves a break in the retina that allows fluid to flow behind it, separating it from the eye wall.
• Symptoms: Rapid vision loss; often requires emergency surgery within 24 hours.

2. Tractional retinal detachment

• Causes: Scar tissue on the retina, commonly due to diabetes.
• Description: Scar tissue contracts and pulls the retina away from the eye wall without a retinal break.

3. Exudative retinal detachment

• Causes: Conditions such as inflammation (uveitis) or leaking blood vessels.
• Description: Fluid leaks under the retina from blood vessels, causing detachment.

Symptoms and signs of retinal detachment

• Sudden onset of visual floaters or a shadow (dark or grey curtain) in peripheral vision
• Onset of flashing lights
• Loss of central vision as the peripheral shadow increases
• Some people may not notice immediate vision loss if it occurs in the non-dominant eye

Preventing blindness from retinal detachment

Early diagnosis and treatment by a retinal surgeon are crucial, especially when the detachment is limited to the peripheral retina (macula-on or macula-sparing). Prompt examination within 24 hours of noticing sudden vision changes is essential.

Retinal detachment surgery and treatment

Treatment varies based on the type of retinal detachment and individual's age:

1. Vitrectomy surgery

• Description: Microsurgery involving removal of the vitreous gel, drainage of fluid from under the detachment, sealing of the retinal break with laser or cryotherapy, and placement of a gas or silicone oil bubble to reattach the retina.
• Usage: Preferred for most retinal detachments.

For more detailed information on vitrectomy and post-operative care, visit our vitrectomy page.

2. Scleral buckling surgery

• Description: Involves placing a silicone band around the eye wall to push it inward against the retinal break, with cryotherapy or laser to seal it.
• Usage: Generally preferred for retinal holes.

3. Pneumatic retinopexy

• Description: Injection of a gas bubble into the eye, followed by cryotherapy or laser.
• Usage: Occasionally used as an alternative to vitrectomy.

4. Laser surgery

• Description: Laser treatment alone can be considered for small peripheral retinal detachments.

Conclusion

Retinal detachment is a serious condition requiring prompt medical attention. Understanding the types, causes, symptoms, and treatment options is essential for timely intervention and preventing permanent vision loss.

At OCL Vision, we offer emergency same-day retina treatments to prevent vision loss. Please call our team for any medical emergencies.