Retinal Detachment

Key Points

Overview

There are three main types:

The retina is the thin, light-sensitive layer lining the back of the eye. In retinal detachment, it separates from the tissue that supplies it with oxygen and nutrients. Without prompt treatment, the detached area stops working and vision loss can become permanent. It is usually painless, so warning signs such as flashes, floaters or a spreading shadow are important to act on quickly. Treatment is surgical in most cases and aims to reattach the retina and seal any breaks.

• Rhegmatogenous, caused by a tear that lets fluid get under the retina
• Tractional, where scar tissue pulls the retina away, often in diabetes
• Exudative, where fluid builds up behind the retina without a tear

Signs and Symptoms

People with retinal detachment may experience:

• A sudden increase in floaters, specks or cobweb-like shapes drifting across vision
• Flashes of light in one or both eyes, especially in side vision
• A dark shadow or curtain spreading across part of the visual field
• Blurred or distorted vision that comes on suddenly
• Straight lines looking wavy or bent
• Loss of central vision if the detachment reaches the macula

Things That Increase the Risk

Retinal detachment is more likely with:

• Older age, especially over 40
• Severe short-sightedness (high myopia)
• Previous eye surgery, such as cataract removal
• A previous retinal detachment in either eye or a family history
• Serious eye injury
• Diabetic retinopathy or other retinal disease

Diagnosis

Diagnosis typically involves:

• Dilated eye examination with an ophthalmoscope
• Slit-lamp examination of the retina
• Optical coherence tomography (OCT) scan
• Ocular ultrasound if the view into the eye is blocked
• Visual acuity and visual field testing

Treatment & Management

Treatment depends on the type and extent of the detachment and whether central vision is affected. Most detachments need surgery, ideally without delay.

• Keep head positioning exactly as instructed
• Avoid flying or high altitude while a gas bubble is present
• Use prescribed eye drops on schedule
• Attend every follow-up appointment

• Laser or freezing treatment to seal early tears
• Pneumatic retinopexy for selected simpler detachments
• Scleral buckling surgery
• Vitrectomy with gas or silicone oil support

Prevention

Steps that can help include:

Not all retinal detachments can be prevented, but early detection of tears greatly reduces the risk of a full detachment.

• Regular dilated eye exams if you are highly short-sighted or have had eye surgery
• Protective eyewear during sports and risky activities
• Good control of diabetes and blood pressure
• Prompt eye check after any new flashes or floaters
• Treating retinal tears as soon as they are found

Related Conditions

You might also want to learn about:

• Posterior Vitreous Detachment
• Diabetic Retinopathy
• Macular Hole
• Cataract