Retinal detachments occur when the retina becomes separated from the back of the eye. Although this is occasionally caused by trauma, diabetic retinopathy or even systemic diseases, we more commonly see that retinal detachments occur due to aging rather than from an antecedent event. In particular, retinal tears are an age-related problem that most often precedes a retinal detachment.
The retina is held in place by a layer of tissue that lines the back of the eye wall. This tissue layer, by removing fluid, forms a vacuum between the retina and eye wall. If a tear develops in the retina, fluid may then migrate through the tear at a faster rate than the tissue layer can remove the fluid. This leads to an accumulation of fluid behind the retina (subretinal fluid) that may cause the retina to detach the from the tissue layer and eye wall.
Flashes and floaters are common symptoms of retinal tears. Retinal detachments are painless and frequently lead to a “curtain” blocking some or all of the visual field. If a patient experiences a sudden loss of vision, he should contact his optometrist or ophthalmologist immediately.
In the case of retinal detachments, the prognosis for recovery is greatly enhanced by receiving immediate care. Retinal detachments may be repaired by several mechanisms, including pneumatic retinopexy, scleral buckle and vitrectomy; these are procedures that are usually performed in an outpatient surgery setting. The actual treatment option used will depend on the type and severity of the detachment.
The animation below provides an overview of retinal detachments.