Retinal Detachment

Retinal detachment is a disorder of the eye in which the retina separates from its underlying layer of support tissue. Initial detachment may be localized, but without rapid treatment, the entire retina may detach, leading to vision loss and blindness. Retinal Detachment is a medical emergency.

Retinal DetachmentThe retina is a thin layer of light sensitive tissue on the back wall of the eye. The optical system of the eye focuses light on the retina much like light is focused on the film in a camera. The retina translates that focused image into neural impulses and sends them to the brain via the optic nerve. Occasionally, an injury or trauma to the eye or head may lead to posterior vitreous detachment and a tear can occur. The tear allows vitreous fluid to seep through it under the retina, and peel it away like a bubble in wallpaper.

A retinal detachment is commonly preceded by a posterior vitreous detachment which gives rise to these symptoms:

  • Flashes of light – very brief in the extreme peripheral (outside of center) part of vision
  • A sudden dramatic increase in the number of floaters
  • A ring of floaters or hairs just to the temporal side of the central vision
  • A slight feeling of heaviness in the eye

Although most posterior vitreous detachments do not progress to retinal detachments, those that do produce the following symptoms:

  • A dense shadow that starts in the peripheral vision and slowly progresses towards the central vision
  • The impression that a veil or curtain was drawn over the field of vision
  • Straight lines (edge of the wall, road, etc.) that suddenly appear curved

If you have these symptoms please call our office immediately at (757) 483-0400. If after hours our answering service will give you instructions.

Treatment Options

There are several methods of treating a detached retina which all depend on finding and closing the breaks which have formed in the retina.

Cryopexy and Laser Photocoagulation

Cryotherapy (freezing) or laser photocoagulation are occasionally used alone to wall off a small area of retinal detachment so that the detachment does not spread.

Scleral buckle surgery

Scleral buckle surgery is an established treatment in which the eye surgeon sews one or more silicone bands to the sclera (the white outer coat of the eyeball). The bands push the wall of the eye inward against the retinal hole, closing the break or reducing fluid flow through it and reducing the effect of vitreous traction thereby allowing the retina to re-attach. Cryotherapy (freezing) is applied around retinal breaks prior to placing the buckle. The most common side effect of a scleral operation is myopic shift, meaning the operated eye will be more short sighted after the operation.

Vitrectomy

Vitrectomy is a commonly used treatment for retinal detachment. It involves the removal of the vitreous gel and are usually combined with filling the eye with either a gas bubble or silicon oil. Advantages of using gas in this operation is that there is no myopic shift after the operation and gas is absorbed within a few weeks. A disadvantage is that a vitrectomy always leads to more rapid progression of a cataract in the operated eye.