What Is a Detached Retina?

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A detached retina occurs when the retina, a layer of tissue that covers most of the back of the eye, separates from its anchored position. Eye trauma is the most common cause, and the symptoms—blurred vision and/or seeing floaters or flashing lights—are sudden in such cases. This condition is a true eye emergency and requires immediate treatment to avoid severe vision loss or blindness. An eye examination can identify the injury (and its risk factors) and confirm the need for an interventional procedure to treat it.

Types of Detached Retina

The retina is composed of a light-sensitive layer of neural cells that line the inside of the eyeball. Much like a camera, the retina captures light rays and turns them into electrical impulses. These impulses travel along the optic nerve to the brain, where they are converted into pictures.

The retina lies on top of the choroid, which is a vascular tissue responsible for nourishing the retina. Retinal detachment occurs when the neurosensory retina is detached from the retinal pigment epithelium. When subretinal fluid accumulates in this space, a serous retinal detachment occurs.

There are three types of retinal detachment:

  • Rhegmatogenous retinal detachment: This is the most common type. It is caused by tears or holes in the retina, referred to as retinal breaks.
  • Tractional retinal detachment: This type of detachment occurs when scar tissue or other abnormal tissue grows on the surface of the retina, pulling the retina away from the layer beneath it.
  • Exudative retinal detachment: This occurs when fluid or blood flows under the retina, separating it from the layer beneath. Exudative retinal detachment is most often a complication of other conditions including, macular degeneration, eye tumors, and high blood pressure.

Detached Retina Symptoms

Retinal detachment typically involves one eye. While it isn't common, the condition can happen in both eyes at the same time. Some retinal detachments associated with retinal breaks at lattice can occur suddenly. As the retina becomes detached, it doesn't cause pain, but it permanently affects vision.

Common visual symptoms of a detached retina—which tend to be disturbing, but subtle—include:

  • Floaters that may appear as grey spots, strings, or spider webs floating in your field of vision
  • Flashes of light
  • What seems like dark curtain or veil moving over your whole field of vision
  • Blurry vision
  • Seeing a shadow in the side of your visual field

It might not be obvious that only one of your eyes is affected unless you cover one eye at a time.

You should not expect to feel any pain in your eye due to retinal detachment itself. However, eye pain (as well as head or face pain and bruising) can result from the causative injury.

When a chronic medical condition is the cause of a detached retina, the effects can instead occur gradually.

If you experience any of the symptoms of a retinal detachment, do not hesitate to seek medical attention. Time is of the essence in the treatment of a retinal detachment. Early treatment can improve the chance of restoring your vision.

Causes

Retinal detachment is primarily caused by lattice degeneration, an anatomical finding in certain patients, especially those who are extremely nearsighted. Certain risk factors can make you more prone to a detached retina if you experience a blow or injury to your head, face, or eye that causes eye-bleeding or intense eye movements (e.g., hitting an airbag during a car accident).

But some detached retinas occur spontaneously with no recent trigger due to slow changes that affect the eye or certain diseases and conditions:

  • The vitreous, a gel-like fluid that fills the cavity of the eye, surrounds the retina. As you age, the vitreous can liquify and separate from the retina, predisposing you to a posterior vitreal detachment (PVD), which increases the risk of a retinal detachment.
  • Certain chronic diseases, like diabetes and wet macular degeneration, can lead to new blood vessel growth or scarring, which displaces the retina from the choroid and vitreous.

Risk Factors

Several factors can increase your risk of developing a retinal detachment with trauma or even in the absence of it, including:

Nearsightedness is weak distance vision caused by the shape of the lens in the eye, and this elongated shape makes the retina more likely to detach.

Diagnosis

The diagnosis of a detached retina requires a careful eye examination and typically involves diagnostic tests as well. These tests allow your doctor to visualize the structures inside your eye so that a detachment, vascular changes, inflammation, or other problems can be visibly seen.

Your optometrist or ophthalmologist may dilate your pupils using eye drops. A binocular indirect ophthalmoscope may be used to obtain a three-dimensional view to examine the inside of your eye.

In some instances, blood may obstruct the view, making it difficult for your retina to be examined. An ultrasound device can be used to look at your eye, especially if there is dense bleeding inside your eye. The ultrasound device produces sound waves that bounce off the back of the eye, forming a picture that helps your doctor see if your retina is truly detached.​

Treatment

This condition requires interventional treatment, and the detachment cannot be repaired with medication. There are several treatment options that can be considered, which should be discussed with your doctor.

The ultimate treatment chosen depends on the type, severity, and location of your retinal detachment. For example, a detached retina may be associated with retinal tears, especially in the context of trauma, and you may need repair of tears along with the repair of your detachment.

Procedures used to repair a detached retina include:

  • Lasers: This procedure uses lasers to create small scars in your eye to repair a retinal tear or, in the case of detachment, help your retina adhere to the choroid.
  • Cryotherapy: This procedure uses a freezing method to secure the retina back into place or repair a tear in the retina.
  • Pneumatic retinopexy: If you have this procedure, your eye would be injected with a gas bubble that presses against the retina, placing it back into the proper position. This may be an option for you if your retina detaches in the upper part of your eye.
  • Vitrectomy: This procedure involves the removal of vitreous gel from your eye so the retina can be pushed back into place, usually with the placement of silicone oil.
  • Scleral buckle: This is a procedure in which a small band of silicone is attached to the outside of the eye to hold the retina in place, allowing the retina to reattach to the posterior lining. Once it is placed, the buckle is not visible without a special examination device.

Keep in mind that a procedure to repair a retinal detachment can help you avoid serious vision loss. That said, you may still experience some residual vision loss and your vision might not return to normal, even after a surgical repair.

A Word From Verywell

Retinal detachment is a serious eye condition that requires immediate professional attention. If left untreated, it can cause total vision impairment in the affected eye.

If the early signs and risk factors of a detached retina are identified, however, most detached retinas can be surgically reattached with vision partially or completely restored.

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