Retinal Detachment: Causes and Effects
What is retinal detachment?
Retinal detachment is an eye condition in which the retina is not in its normal position and causes floaters, vision loss described as “curtains”, and flashes of light. The retina is a light-sensitive layer of tissue in the back of the eyeball near the optic nerve which takes in light to send signals to the brain in order to create images and visual recognition. When this is damaged, it can cause permanent blindness because the retina is crucial in receiving visual information. Retinal detachment is reversible with proper care and treatment. Treatment options should always be discussed with your eye doctor before further procedure.
The first step to identifying retinal detachment is taking a retinal exam in which an eye doctor will flash a bright light with special lenses to see the entire eye and allow them to find tears, holes, or other damages. Another way to identify retinal detachment is ultrasound imaging for when there is bleeding in the eye since blood makes it difficult to look through the eye with the light. If during the first appointment, nothing is found, it is best to have a follow-up because the eye may develop a delayed retinal tear which should seek attention immediately if symptoms persist or intensify.
Symptoms of retinal detachment include:
Floaters (specks, squiggles, lines, threads, etc that move across your vision)
Flashes of light
Vision loss described as a “curtain” or shadow in the peripheral (side) vision or in the middle of your vision
Anyone is susceptible to retinal detachment, however, there are some who are at a higher risk.
Those with a higher risk of developing retinal detachment include if you have had:
A family member who has had retinal detachment
A serious eye injury
Eye surgery
Severe nearsightedness (myopia)
Diabetic retinopathy
Eye diseases
Lattice degeneration (thinning of the retina)
Posterior vitreous detachment
Retinoschisis
Causes of Retinal Detachment
There are three types of retinal detachments which stem from various causes. All require medical attention if symptoms occur.
Rhegmatogenous retinal detachment: The most common type of retinal detachment, it is caused by small tears or breaks in the retina that may eventually deepen and cause long lasting damages to the eye if not treated or monitored immediately. The vitreous or the gel-like fluid in the middle of the eye may get into the retina due to these tears which will result in the retina detaching from the eye. Moreover, aging is a common cause as the vitreous changes in texture and size and thus may pull on the retina and form tears into it. Other causes thereof are nearsightedness, eye injuries, or eye surgery.
Tractional retinal detachment: Tractional retinal detachment is caused by scar tissue on the retina pulling the retina away from the eye. This type of retinal detachment is most common with those with diabetes as the retina detaches because of diabetic retinopathy which is an eye condition in which blood vessels in the eye become damaged which in turn causes scarring in the retina which can pull the retina away from the eye.
Exudative retinal detachment: Rather than tears or breaks in the eye, exudative retinal detachment is caused by fluid behind the retina which can push the retina away from the eye. Common causes of fluid build up is leaking blood vessels, swelling, injury or trauma to the eye, tumors, and inflammation to the eye.
Treatments
Treatments will have to be discussed with your eye doctor to be the most effective for you and may even require a combination of treatments.
Common treatments for retinal detachment include:
Laser therapy/cryopexy (freeze treatment): seal tears in the retina by creating a scar to hold it in place by using a medical laser or freezing device
Pneumatic retinopexy: Eye care provider will inject a gas bubble into the eye which will close the tear then it will be sealed by either laser or freezing. Thereafter, the retina should stick to the eye wall after the body reabsorbs the fluid left by the treatment and absorbs the gas bubble over time.
Scleral buckle: A miniscule, practically invisible, silicone band or sponge (buckle) is surgically placed around the eye to permanently hold the retina in place, after tears will be sealed by lasers or cryopexy, and a gas bubble may be injected or fluid drainage under the retina may occur to help the process.
Vitrectomy: The vitreous is surgically removed to prevent further tears, then the present tears or holes are sealed by laser therapy or cryopexy, and finally a gas or oil bubble will be placed in the eye to push the retina back into place. An oil bubble will have to be removed a few months later and avoiding high altitudes is the best way to ensure further damages will be prevented because altitude change causes the bubble to change in size and adds pressure to the eye.
Written By: Sunny Han
References
Cleveland Clinic. (2023, June 9). Retinal Detachment (detached retina): Symptoms, Treatment & Prevention. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/10705-retinal-detachment
Healthline Editorial Team. (2015). Retina. Healthline; Healthline Media. https://www.healthline.com/human-body-maps/retina#1
Mayo Clinic. (2019). Retinal detachment - Diagnosis and treatment - Mayo Clinic. Mayoclinic.org. https://www.mayoclinic.org/diseases-conditions/retinal-detachment/diagnosis-treatment/drc-20351348
National Eye Institute. (2019a). Retinal Detachment | National Eye Institute. Nih.gov. https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/retinal-detachment
National Eye Institute. (2019b). Types and Causes of Retinal Detachment | National Eye Institute. Nih.gov. https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/retinal-detachment/types-and-causes-retinal-detachment
