Overview:
Retinal detachment, also known as a detached retina, is a serious eye condition that can cause blindness if not treated. It affects the retina, a layer of tissue that lines the back of the eye. It is caused by the retina pulling away from the tissues that support it. Flashes of light, floaters, or seeing a shadow in vision are all symptoms. Floaters are dark spots or squiggles that appear in vision.
As with retinal tears, one may experience warning signs like these before the retina detaches. Retinal detachment frequently occurs spontaneously or unexpectedly. Age, nearsightedness, a history of eye surgeries or trauma, and a family history of retinal detachments are all risk factors.
Symptoms:
Some people have no symptoms of retinal detachment, whereas others do. It depends on the severity of the detachment — if a larger portion of the retina detaches, you are more likely to experience symptoms.
The following symptoms of retinal detachment can occur suddenly:
- Seeing flashes of light.
- Seeing a lot of floaters — flecks, threads, dark spots and squiggly lines that drift across your vision. (Seeing a few here and there is normal and not cause for alarm.)
- Darkening of your peripheral vision (side vision).
- Darkening or shadow covering part of your vision.
Causes:
There are three different types of retinal detachment:
- Rhegmatogenous (reg-ma-TODGE-uh-nus). These types of retinal detachments are the most common. Rhegmatogenous detachments are caused by a hole or tear in the retina that allows fluid to pass through and collect underneath the retina. This fluid builds up and causes the retina to pull away from underlying tissues. The areas where the retina detaches lose their blood supply and stop working, causing you to lose vision.
The most common cause of rhegmatogenous detachment is aging. As you age, the gel-like material that fills the inside of your eye, known as the vitreous (VIT-ree-us), may change in consistency and shrink or become more liquid. Normally, the vitreous separates from the surface of the retina without any complications — a common condition called posterior vitreous detachment (PVD). One complication of this separation is a tear.
As the vitreous separates or peels off the retina, it may tug on the retina with enough force to create a retinal tear. Left untreated, the liquid vitreous can pass through the tear into the space behind the retina, causing the retina to become detached.
- Tractional. This type of detachment can occur when scar tissue grows on the retina’s surface, causing the retina to pull away from the back of the eye. Tractional detachment is typically seen in people who have poorly controlled diabetes or other conditions.
- Exudative. In this type of detachment, fluid accumulates beneath the retina, but there are no holes or tears in the retina. Exudative detachment can be caused by age-related macular degeneration, injury to the eye, tumors or inflammatory disorders.
Risk Factors:
Risk for retinal detachment increases with age. A person is also at higher risk if s/he has or had:
- Eye injury.
- Family history of retinal detachment.
- Intraocular surgery (any surgery involving the eye, like cataract surgery).
Having certain eye conditions also raises risk for retinal detachment:
- Significant myopia, or nearsightedness.
- Posterior vitreous detachment, where vitreous (thick fluid in the middle of the eye) pulls away from the retina.
- Other eye conditions, such as lattice degeneration (retina thinning).
- History of retinal tears or detachments in the other eye.
Diagnosis:
To diagnose retinal detachment, an eye exam is required. A dilated eye exam will be performed by an eye care provider to check the retina. They will put eye drops in your eyes. The drops dilate (enlarge) the pupil. After a few minutes, the provider can examine the retina closely.
Following the dilated eye exam, the provider may recommend additional tests. These tests are non-invasive and will not cause any discomfort. They allow the provider to see the retina more clearly and in greater detail:
OCT (optical coherence tomography): For this imaging, the patient is given dilating eye drops. The patient is then positioned in front of the OCT machine. The patient should rest his or her head on a support to keep it still. The machine scans but does not touch the eye.
Eye (ocular) ultrasound: No dilating drops are required for this scan, but the provider may use drops to numb the eyes so the patient does not feel any discomfort. The patient sits in a chair and rests his head on a support to keep it still. To scan the eye, the provider gently places an instrument against the front of it. Next, have the patient close their eyes. The provider applies gel to the eyelids. With his or her eyes closed, the patient moves his or her eyeballs while the doctor scans them with the same instrument.