Retinal Detachment

​

A retinal detachment is a serious eye condition in which the retina — the thin, light-sensitive layer lining the back of the eye — separates from its normal position. Because the retina depends on a constant blood supply to function, a detachment can cause permanent vision loss if not treated promptly. Retinal detachment is considered a medical emergency.

​

 

What Causes Retinal Detachment?

​

Retinal detachment most often occurs due to age-related changes in the vitreous gel inside the eye. As the vitreous shrinks and pulls away from the retina, it can sometimes create a tear. Fluid can then pass through the tear and lift the retina away from the underlying tissue.

There are three main types of retinal detachment:

​

1. Rhegmatogenous Retinal Detachment (most common)

​

Caused by a retinal tear or hole that allows fluid to collect under the retina.

​

2. Tractional Retinal Detachment

​

Occurs when scar tissue on the retinal surface pulls the retina away, most commonly seen in advanced diabetic retinopathy.

​

3. Exudative (Serous) Retinal Detachment

​

Occurs without a tear, due to fluid leakage from inflammation, tumors, or blood vessel abnormalities.

Risk factors include:

​

• Aging and posterior vitreous detachment
   

• High nearsightedness (myopia)
   

• Previous retinal tear or detachment
   

• Eye trauma
   

• Prior eye surgery (especially cataract surgery)
   

• Family history of retinal detachment
   

• Diabetic eye disease

• ​
   

 

Symptoms

​

Retinal detachment is typically painless, but symptoms can appear suddenly and worsen quickly. Warning signs include:

​

• Sudden onset or increase in floaters
   

• Flashes of light, especially in side vision
   

• A shadow, curtain, or dark area moving across vision
   

• Sudden decrease in vision
   

Any of these symptoms require immediate eye evaluation.

​

 

How Retinal Detachment Is Diagnosed

​

Diagnosis is made through a dilated retinal examination. Additional testing may include:

​

• Retinal imaging or photography
   

• Optical Coherence Tomography (OCT) in select cases
   

• Ultrasound imaging if the view of the retina is obscured
   

Prompt diagnosis improves the chance of successful repair.

​

 

Treatment Options

​

Treatment depends on the type, size, and location of the detachment and how long it has been present.

​

Retinal Tears (Before Detachment)

​

• Laser photocoagulation or cryotherapy can seal retinal tears and prevent progression to detachment.
   

Surgical Repair

​

Common surgical options include:

​

• Pneumatic retinopexy – a gas bubble is injected into the eye to help reattach the retina
   

• Scleral buckle – a silicone band is placed around the eye to relieve vitreous traction
   

• Vitrectomy – removal of the vitreous gel and repair of the retina, often combined with gas or silicone oil
   

Some detachments require more than one procedure.

​

 

Outcomes and Prognosis

​

Visual outcomes depend on:

​

• How quickly treatment is performed
   

• Whether the macula (central retina) was detached
   

• The overall health of the eye
   

When treated early, many retinal detachments can be successfully repaired. Vision often improves gradually over weeks to months, though some permanent vision loss may occur, particularly if the macula was detached.

​

 

Living After Retinal Detachment

​

After treatment, patients may need to:

​

• Maintain specific head positioning
   

• Avoid air travel while a gas bubble is present
   

• Attend frequent follow-up visits
   

Patients who have had a retinal detachment are at higher risk for problems in the other eye, making regular eye exams essential.

​

 

When to Seek Immediate Care

​

Contact an eye care professional right away if you experience:

​

• New flashes or floaters
   

• A curtain or shadow in your vision
   

• Sudden vision loss
   

Early treatment can be vision-saving.