An Overview of Retinal Detachment

Vision loss, floaters, and flashing lights may be a medical emergency

In This Article

Table of Contents

Retinal detachment is painless, but it causes distress because it affects your vision. If your retina becomes detached, you might suddenly see spots or lights or your vision may become blurred. This condition is a true eye emergency and requires immediate treatment to avoid severe vision loss or blindness.

Trauma of the eye can cause retinal detachment. Aging and nearsightedness can make you more prone to the condition. An eye examination can identify a retinal detachment, and the situation can be treated with interventional procedures.

If you or a loved one develop symptoms of a retinal detachment, be sure to seek medical attention right away—a delay in treatment will worsen your outcome.

Symptoms

Retinal detachment typically involves one eye. While it isn't common, the condition can happen in both eyes at the same time.

You should not expect to feel any pain in your eye during or after a retinal detachment. The visual symptoms are often disturbing, but subtle.

The effects can occur gradually if your retinal detachment is caused by a chronic medical condition. And when trauma causes retinal detachment, the symptoms occur suddenly, often along with other symptoms (not directly related to your retinal detachment) as well—such as bruising of the face, or pain of the eye, head, or face.

Common visual symptoms of a retinal detachment include:

  • Floaters that may appear as grey spots, strings, or spider webs floating in your field of vision
  • Flashes of light
  • A dark curtain or veil moving over your vision
  • Blurry vision

When you have a retinal detachment, it might not be obvious that only one of your eyes is affected unless you cover one eye at a time.

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 often caused by trauma. Some retinal detachments occur spontaneously with no recent trigger due to slow changes that can affect the eye, especially with aging.

Risk Factors

Several factors can increase your risk of developing a retinal detachment, making it more likely that you could experience a detachment if you experience trauma—or even in the absence of trauma.

Risk factors that increase the likelihood of retinal detachment include:

  • Previous retinal detachment in one eye
  • History of eye surgery, such as cataract surgery
  • A history of eye trauma, even if it didn't cause retinal detachment
  • Advancing age-related changes in the eye
  • Weak areas in the periphery of the retina, often due to blood vessel overgrowth
  • A family history of retinal detachment
  • A tumor in the eye
  • Diabetes
  • High level of nearsightedness

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

How Retinal Detachment Happens

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 responsible for nourishing the retina. The vitreous, a gel-like fluid that fills the cavity of the eye, lies in this area as well.

Retinal detachment occurs when the retina separates from the choroid.

As we age, the vitreous can liquefy and separate from the retina, predisposing to a posterior vitreal detachment (PVD). Certain diseases, like diabetes, can lead to retinal detachment due to new blood vessel growth or scarring, which causes contractions in the retina.

Diagnosis

The diagnosis of a retinal detachment 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 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.​

Types

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 detachment 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.

Treatment

There are several treatment options if you have a retinal detachment. This condition requires interventional treatment, and the detachment cannot be repaired with medication.

You and your doctor will discuss your options. Your treatment depends on the type, severity, and location of your retinal detachment.

Procedures used to repair a retinal detachment include:

  • 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.
  • 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.
  • Cryotherapy: This procedure uses a freezing method to secure the retina back into place or to repair a tear in the retina.
  • Lasers: This procedure uses lasers to create small scars in your eye to repair a tear in the retina.
  • 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.

Keep in mind that a procedure to repair a retinal detachment can help you can avoid serious vision loss. Nevertheless, you can 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 retinal detachment are identified, however, most detached retinas can be surgically reattached with vision partially or completely restored.

Was this page helpful?

Article Sources