What is retinal detachment?

Retinal detachment is a serious condition of the eye in which the retina stops receiving oxygen. The symptoms of a retinal detachment can be frightening. Objects might appear to float across your eye, or a gray veil may move across your field of vision. If not treated quickly, a retinal detachment can cause you to lose your vision. Retinal detachment repair is a surgery that is used to restore circulation to the retina and preserve vision. If you have the symptoms described above, you should call your ophthalmologist or go to the emergency department immediately.

Your retina is the part of your eye that sends images through your optic nerve to the brain. Your retina contains millions of cells that detect light like a camera. It is part of the very back of your eyeball and is essential to your vision.

Retinal detachment occurs when the retina pulls away from the back of the eye and the blood supply. Without a blood supply, the retinal cells will start to die. This can cause permanent damage to your vision. If the macula (central vision area) begins to loosen, your vision may be permanently damaged. If the macula completely detaches, you may lose your vision entirely. Reattaching the retina quickly is essential to prevent such a serious complication.

Retinal detachment can occur because the vitreous fluid of the eye (a gel-like liquid) retracts from the back of the eye, pulling the retina and tearing it. That tear can then pull away from the back of the eye and detach the retina. Some causes and risk factors of retinal detachment include glaucoma, severe trauma, nearsightedness, previous cataract surgery, previous retinal detachment in your other eye, or family history of retinal detachment.

There are several types of surgery to repair a detached retina. A simple tear in the retina can be treated with freezing, called cryotherapy, or a laser procedure. Different types of retinal detachment require different kinds of surgery and different levels of anesthesia. The type of procedure your doctor preforms will depend on the severity of retinal detachment.

One method of retinal detachment repair is pneumatic retinopexy. In this procedure, a gas bubble is injected into the eye. The bubble presses against the detached retina and pushes it back into place. A laser or cryotherapy is then used to reattach the retina firmly into place. The gas bubble will dissolve in a few days. A pneumatic retinopexy can be done in an ophthalmologist’s office.

In more severe tears, a procedure called a scleral buckle may be performed. During a scleral buckle a doctor will place a flexible band around the eye to counteract the force that is pulling the retina out of place. The fluid behind the detached retina will be drained, and the retina should return to its normal place in the back of the eye. This procedure is done in a hospital, operating room, or surgery clinic. Local or general anesthesia will be used, and you may need to stay overnight in the hospital.

A vitrectomy is a procedure done for serious retinal detachments. It may require partially removing the vitreous fluid inside the eye. Local anesthesia is used and the procedure is usually done in a surgical clinic.

Retinal detachment repair is usually done on an emergency basis. Be sure to tell your doctor about any medications you may be taking that could interfere with the surgery or the anesthesia.

Surgery always carries some risk. If you have general anesthesia, it can interfere with breathing. Some people have serious reactions to the medication.

If the retina was damaged before reattachment, there can be permanent loss of vision.

Usually the retina can be attached in a single operation, but sometimes multiple procedures are required. More than 90 percent of detachments can be repaired. In the less than 10 percent of detachments that cannot be repaired, the patient will have either poor vision or no vision in that eye.

The success of a retinal repair depends on the seriousness of the tears and detachment and how much scar tissue was formed in the retina. If the macula or central portion of the retina was not affected, vision will be good. If the macula was detached for a long time, some vision will return, but it will often be less than 20/200, which is legally blind. It may take several months of healing after surgery to determine how much vision will return.