Retinal Detachment: Signs, Causes, Treatments

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The retina covers the back of the eye. It has light-sensitive cells that detect color and transmit visual signals to the brain through the optic nerve. The retina is normally flat and securely anchored to the back part of the eye.

When the retina breaks free of its attachments, this is called a detached retina. It’s a medical emergency very capable of causing blindness if not treated immediately. When the retina detaches, its delicate cells are deprived of oxygen and nutrients. Once these cells die, lost vision is likely permanent.

The longer treatment is delayed, the higher the chance of cell death and a further worsening of the detachment.

Causes and Risk Factors

Retinal detachment can happen suddenly to anyone for no apparent reason and without warning. However, the condition has several known causes and risk factors:

Trauma to the head, face, or eyes
Peripheral retinal degeneration
High myopia
Diabetes and diabetic retinopathy
Family history
Posterior vitreous detachment
Previous eye surgery
Aging, especially over age 50

Any trauma or blow to the head or facial area could directly cause the retina to detach. This is a particular concern for boxers and football players.

Peripheral retinal degeneration refers to an eye condition where the outside edges of the retina weaken. This is sometimes called lattice degeneration. In the weakened areas, it’s more likely the retina may begin to pull away from the back of the eye.

High myopia means that someone is very nearsighted. This is typically defined as a sphere correction of -6.00 diopters or higher. The risk of a retinal tear or detachment is greater for these people because their eyeball is more elongated.

This elongation causes light entering the eye to focus in front of the retina instead of directly on it. This elongation also raises the retinal detachment risk because the retina is stretched more tightly across the back of the eyeball than it normally would be.

High myopia may also be associated with a degeneration of the vitreous, the jelly-like substance inside the eyeball. When the vitreous breaks down, it may pull away from the retina and cause it to detach.

Vitreous degeneration also occurs as part of the normal aging process and may cause some minor tugging of the retina. This tugging may result in the sensation of flashes of light at the very outer right and left periphery of vision.

Vitreous degeneration and posterior vitreous detachment due to aging are normally not associated with retinal detachment. As we age, the vitreous becomes more liquid (vitreous degeneration) and eventually pulls away from the retina (vitreous detachment).

Diabetes causes problems with the eyes because consistently high levels of blood sugar damage all blood vessels, particularly the small ones at the back of the eye. These blood vessels nourish the retina cells, and when they’re weakened, they can’t do their jobs.

The body tries to compensate by growing new blood vessels, but it doesn’t work. These new blood vessels are weak and break open easily. They bleed into the area, causing damage and scar tissue. This weakens the retina, making a detachment more likely.

Another diabetic eye condition called macular edema may also cause a retinal detachment. This condition occurs when the macula’s retinal center fills with fluid from leaky, faulty blood vessels. The retina is supposed to be flat, so any swelling, especially from underneath, may contribute to retinal detachment.

Retinal Detachment Symptoms

These may include:
Flashing lights
Sudden increase in floaters
Sudden blurry vision in one eye
A feeling of a curtain falling over the visual field

None of these symptoms should ever be ignored, and none are likely to have a minor cause. If you experience any of these symptoms, contact your eye doctor or go to the nearest emergency room.

Diagnosis

You will receive a full eye exam, including drops to dilate the pupils completely. Through dilated pupils, your eye doctor will have a direct view of your retina. Your doctor will likely photograph your retina for documentation and further study.

During a retinal exam, your eye doctor may order retinal imaging tests. They may also use a small, round magnifier tool that looks something like a jeweler’s loupe. Your doctor will ask you to move your eyes from side to side and up and down as they observe your retinas with a magnifier tool.

If you’re experiencing symptoms like flashes and floaters and your eye doctor can find no sign of retinal detachment, you will likely need to have a repeat exam in a couple of weeks to make sure no retinal detachment is present.

Treatment

Only conventional surgery, laser surgery, or cryosurgery is effective for treating a detached retina. A retina specialist typically performs these procedures. The sooner the damage is repaired, the more likely the most vision will be saved or preserved.

There are several retinal detachment procedures:

Scleral buckling surgery

This is often combined with vitrectomy. The surgeon uses a sponge or silicone to attach the retina to the sclera or the white part of the eye.

Vitrectomy

This means the removal of the vitreous humor, the fluid inside the eyeball. The procedure allows the surgeon better access to the retina and helps reduce tension on the retina.

Pneumatic retinopexy

This is typically an outpatient procedure using an expanding gas bubble injected into the eye. The surgeon will guide your position until the gas bubble presses against the detached area and pushes it against the back of the eye. At that point, a freezing device seals the retina back in place.

Both lasers and cryo techniques are used in retinal detachment surgery. If the device is a laser, the process is called photocoagulation. If it’s a freezing probe, the procedure is called cryopexy.

Preventing Retinal Detachment

Sometimes, retinal detachment is unavoidable. However, you can take precautions to wear protective headgear during contact sports like boxing and football.

If you’re a parent with a myopic child, ask the child’s eye doctor about myopia control methods. If you can limit your child’s myopia, you may be able to reduce their chances for retinal detachment.

Find a Top Eye Doctor Near You

One of your best defenses against retinal detachment is a regular comprehensive eye exam. It’s important to develop an ongoing relationship with your eye doctor.

We can help you find a top-rated eye doctor in your area. Our professional staff members will find an eye doctor near you who is perfect for your needs. We’ll help you set an appointment, too.

We look forward to working with you.

Published on: May 1, 2022

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