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What is Retinal Detachment?

A thin, light-sensitive layer of tissue lines the inside of the eye and is called the retina. These cells transmit visual messages from the optic nerve to the brain. This action allows you to see.

What is retinal detachment?

People with age-related macular degeneration (AMD) or myopic macular degeneration may be more susceptible to a condition called retinal detachment. Retinal detachment occurs when the retina tears or separates from the back wall of the eye. This is a serious condition that should be treated immediately to prevent or reduce permanent loss of vision.

Three types of retinal detachment

There are three types of retinal detachment and they are:

  • Rhegmatogenous
  • Tractional
  • Exudative

Rhegmatogenous (reg-ma-TODGE-uh-nus)

This is the most common type of retinal detachment. It occurs when the retina tears or breaks, allowing fluid to collect under the retina. This fluid pushes the retina away from the underlayer in back of the eye called the retinal pigment epithelium (RPE). The RPE contains a layer of blood vessels that feed the retina oxygen and other nutrients. Without contact to the RPE, the retina cells stop working and degenerate over time. It is most often caused by changes in the vitreous gel related to aging.

Tractional

In this type of retinal detachment, scar tissue grows on the surface of the retina, causing it to separate from the RPE. This type is less common. It is most often seen in people with poorly controlled diabetes.

Exudative

This type of detachment is often caused by eye diseases such as wet AMD, and eye or head injuries. With exudative detachment, fluid leaks into the area underneath the retina without causing any tears or breaks in the tissue.1,2

Risks for retinal detachment

Retinal detachment occurs more often in whites than in African Americans, and more often in men than women. It happens more in people over 40.2 The most common risk factors and causes of retinal detachment are:

  • Age
  • Poorly controlled diabetes
  • Age-related macular degeneration
  • Myopic macular degeneration3
  • Having retinal detachment in the other eye
  • Family history of retinal detachment
  • Previous eye surgery such as cataract removal
  • Previous eye injury

Symptoms of retinal detachment

There are almost always warning signs that appear before the retina fully detaches. These symptoms include:

  • Sudden appearance of many floaters, tiny cobwebs or specks that float through your vision
  • Flashes of light in one or both eyes that can be seen even when the eyelids are closed
  • Blurred vision
  • Gradually less peripheral (side) vision
  • A shadow that falls over your vision like a curtain that can extend from any direction

Retinal detachment is painless, but it is a medical emergency that requires immediate treatment.1,2

Treatment for retinal detachment

Surgery is almost always needed to prevent or repair retinal detachment. The good news is that, if caught early, current treatments are over 90 percent successful in restoring or maintaining vision.2

Not fully detached:

Before a tear or hole in the retina causes it to fully detach, laser surgery (photocoagulation) or freezing (cryopexy) may be used to prevent a full detachment. Both of these techniques cause a scar to weld the retina in place and often can be performed in your doctor’s office.

Fully detached

If the retina has fully detached, surgery in the operating room will be required. The type of surgery your doctor recommends will depend on how advanced the detachment is. Common surgeries for retinal detachment are:

  • Pneumatic retinopexy (RET-ih-no-pek-see), a procedure where air or gas is injected into the eye to push the retina into place against the back wall of the eye. Cryopexy will also be used to repair the tear or break.
  • Scleral (SKLAIR-ul) buckling, where a tiny synthetic band is sewn onto the outside of the eye. This gently pushes the wall of the eye against the detached retina.
  • Vitrectomy (vih-TREK-tuh-me), a procedure that drains the vitreous gel of the eye and replaces it with clear fluid, which helps the retina lie flat. This may be combined with scleral buckling.1,2

It may take several weeks or months for the full results of surgery to become apparent. You may be instructed to avoid flying or traveling to high altitudes for several days to weeks if a gas bubble is placed into your eye as part of the surgery. A second surgery may also be needed.

Jessica Johns Pool | February 2019
  1. Mayo Clinic. Retinal detachment – symptoms. Available at https://www.mayoclinic.org/diseases-conditions/retinal-detachment/symptoms-causes/syc-20351344. Accessed February 13, 2019.
  2. National Eye Institute. Facts About Retinal Detachment. Available at https://nei.nih.gov/health/retinaldetach/retinaldetach. Accessed February 13, 2019.
  3. Bright Focus Foundation. Myopic Macular Degeneration. Available at https://www.brightfocus.org/macular/article/myopic-macular. Accessed February 13, 2019.