Retinal Detachment

The retina is the light-sensitive layer of tissue that lines the inside of the eye and sends visual messages through the optic nerve to the brain. When the retina detaches, it is lifted or pulled from its normal position. If not promptly treated, retinal detachment can cause permanent vision loss.

Causes

An injury to the eye or face can cause a detached retina, as can very high levels of nearsightedness. Extremely nearsighted people have longer eyeballs with thinner retinas that are more prone to detaching.

Cataract surgery, tumors, eye disease and systemic diseases such as diabetes and sickle cell disease may also cause retinal detachments

Symptoms

• Painless event
• Monocular complaints of flashes of light, floaters (specks of pigment or blood), or a "curtain" moving over the field of vision
• Loss of vision or a visual field defect varies and may be gradual or sudden in onset.
• Visual acuity remains normal until the macula is involved.

Signs

• Normal anterior chamber
• Afferent pupillary defect may be present.
• Blood in the vitreous may occur, since bleeding is common with retinal detachment.
• Retina may appear to have an elevation, flap, hole, or an undulatory appearance; direct ophthalmoscopy demonstrates that portions of the retina are in focus while other portions are not.

Diagnosis methods

Retinal detachment is diagnosed using a range of eye tests, including:

• Vision tests
• Examination of the retina
• Ultrasound scan.

Treatment

There are a number of ways to treat retinal detachment.  The appropriate treatment depends on the type, severity and location of the detachment. Without treatment, vision loss can progress from minor to severe or even to blindness within a few hours or days.

Surgery is required to reattach the retina. In most cases, surgery can restore good vision. There are many surgical techniques, such as vitrectomy (removal of the vitreous humor), scleral buckles, gas bubbles, silicone oil, lasers, cryo (freezing), temporary balloons, and diathermy (thermal energy created by radio waves) can all be used to repair retinal detachments.

The success rate of treatment for this condition is high, with around nine out of 10 retinas able to be reattached. Sometimes, a second operation may be needed. After treatment, the person’s vision may improve over subsequent months, but often some vision loss is permanent. A change of prescription glasses is usually required.