by Mayo Clinic
Retinal detachment describes an emergency situation when a critical layer of tissue (the retina) at the back of the eye pulls away from the layer of blood vessels that provides it with oxygen and nutrients.
Retinal detachment leaves the retinal cells deprived of oxygen. The longer retinal detachment goes untreated, the greater the risk of permanent vision loss in the affected eye.
Fortunately, retinal detachment often has clear warning signs. If you go to an eye specialist (ophthalmologist) as soon as warning signs appear, early diagnosis and treatment of retinal detachment can save your vision.
Retinal detachment can occur as a result of:
How retinal detachment occurs
Retinal detachment can occur when vitreous liquid (vitreous humor) leaks through a retinal hole or tear and accumulates underneath the retina. Small retinal holes or tears can develop where the retina has thinned due to aging or with other retinal disorders. Retinal detachment due to a tear in the retina typically develops when there is a sudden separation of the vitreous from the retina. Less commonly, fluid can leak directly underneath the retina, without a tear or break.
As liquid collects underneath it, the retina can peel away from the underlying layer of blood vessels (choroid). The areas where the retina is detached lose their blood supply and stop functioning, so you lose vision.
Aging-related retinal tears that lead to retinal detachment
As you age, your vitreous humor may change in consistency and shrink or become more liquid. Eventually, the vitreous may sag and separate from the surface of the retina — a common condition called posterior vitreous detachment (PVD), or vitreous collapse.
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 tear can progress to a retinal detachment.
PVD can cause visual symptoms. You may see flashes of sparkling lights (photopsia) when your eyes are closed or when you're in a darkened room. New or different floaters may appear in your field of vision.
The following factors increase your risk of retinal detachment:
Retinal detachment is painless, but retinal detachment symptoms almost always appear before it occurs. Retinal detachment symptoms may include:
When to see a doctor
Seek immediate medical attention if you suddenly notice retinal detachment symptoms, such as new floaters or flashes of light in your visual field or if it seems as if a dark curtain has fallen across your visual field.
Tests and diagnosis
Tests and procedures used to diagnose retinal detachment include:
Treatments and drugs
Surgery is used to repair a retinal tear, hole or detachment. Your ophthalmologist can tell you about the various risks and benefits of your treatment options. Together you can determine what treatment is best for you.
Surgery for retinal tears
When a retinal tear or hole hasn't yet progressed to detachment, your eye surgeon may suggest an outpatient procedure, which can usually prevent retinal detachment and preserve almost all vision. Options include:
After your procedure you'll need to remain relatively still for the next two weeks or so, as the bonds created by your procedure strengthen.
Surgery for retinal detachment
Doctors also use surgical procedures to repair retinal detachments. These procedures may be done in conjunction with photocoagulation or cryopexy. The type, size and location of the retinal detachment will determine which surgical approach your eye surgeon recommends. In general, these surgeries can successfully treat most cases of retinal detachment, although a second treatment is sometimes necessary.
Surgery isn't always successful in reattaching the retina. Also, a reattached retina doesn't guarantee normal vision. How well you see after surgery depends in part on whether the central part of the retina (macula) was affected by the detachment before surgery, and if it was, for how long. Your vision may take many months to improve after repair of a retinal detachment. Some people don't recover any lost vision.
There's no way to prevent retinal detachment. However, being aware of the warning signs of a detached retina — floaters, bright flashes of light, or a shadow or curtain that seems to fall across your visual field — could help save your vision. If you notice any of the warning signs of retinal detachment, particularly if you're over age 40, you or a family member has had a detached retina, or you're extremely nearsighted, contact your ophthalmologist immediately.