What is a Retinal Detachment?

The retina is attached to the inner back surface of the eye. Detachment is the pulling away of the retina from its normal position. The separation of the retina from the wall of the eye impairs its normal functioning, resulting in blurred vision.

What causes Retinal Detachment?

The vitreous is a clear gel that fills most of the space in the eye. It is located in front of the retina. With age, the vitreous pulls away from its attachments to the retina, usually without causing problems. Sometimes the vitreous pulls hard enough to tear the retina. Fluid may then pass through the retinal tear and lift the retina off the wall of the eye.

Risk factors for retinal detachment:

• Myopia or near-sightedness
• Injury to the eye
• Previous retinal detachment in the other eye
• Family history of retinal detachment
• Areas of thin/weak retina
• Complicated cataract surgery

Warning symptoms of retinal detachment:

• Flashes of light
• New, or increase in, floaters [black dots in your vision]
• A gray curtain noticed in the field of vision

How is Retinal Detachment diagnosed?

The retina is examined with an instrument called the indirect ophthalmoscope after dilating the pupil. Holes and tears are carefully looked for in the periphery of the retina.

Treatment:

Retinal tears without detachment – Laser photocoagulation or new PASCAL laser (Ultra-fast, PAINLESS and Precise) or cryotherapy is performed around the tear to seal the retina to the back wall of the eye.
Retinal tears with retinal detachment – Requires surgery as soon as possible to put the retina back in its proper position. The longer the retina stays detached, the less the visual improvement after surgery. Scleral buckle surgery – A flexible silicone band is placed around the eye to counter the force pulling on the retina after removing the fluid under the detached retina. Like a belt holding up a fat man’s pants by tighting it at the waist.

Vitrectomy – The vitreous gel pulling the retina is removed from the eye and replaced with a special gas or silicone oil.

Visual recovery – The more severe the retinal detachment and the longer its duration, the less is the visual improvement after surgery. For this reason it is very important to see an ophthalmologist at the first sign of any trouble. If the condition is left untreated it results in loss of useful vision.

What are floaters?

Floaters appear as gray or black specks, lines, or “cobwebs”, worms, rings or dots in front of the eyes. As the eyes move, the floaters move too. They do not follow your eye movements precisely, as they usually drift when the eyes start or stop moving.

What are flashes?

Flashes are sensations of light, when no light is really there. They may appear as many tiny bright lights (like “sparklers”) or like flashes of lightning. Flashes occur when the vitreous jelly pulls on or tears the retina. These flashes usually last for only a second or so, but typically occur repeatedly. They may be more obvious with eye movement or in a dark room.

Are floaters and flashes serious?

Many people have floaters. This happens in over 70% of the population as part of the normal aging process. Floaters that you have had for years, and that show little change, are usually not serious. It is the sudden onset of one or more new floaters that may be serious. The onset of flashes may also be serious.
Anyone with flashes or the sudden onset of a new floater (or floaters) needs a dilated fundus examination (looking at the vitreous and retina with specialized equipment after putting drops to enlarge the pupils).