Retinal Detachment

Eyesight depends on a complex series of interactions between the different parts of the eye. (Read about "The Eye") The retina is the light-sensitive layer of tissue that lines the inside of the eye and sends visual messages through the optic nerve to the brain. (Read about "The Brain" "Nervous System") When the retina detaches, it is lifted or pulled from its normal position. If not promptly treated, retinal detachment can cause permanent vision loss. In some cases, there may be small areas of the retina that are torn. These areas, called retinal tears or retinal breaks, can lead to retinal detachment.

Symptoms

Symptoms, according to the National Eye Institute (NEI) include a sudden or gradual increase in the number of floaters in the field of vision and/or light flashes in the eye or the appearance of a curtain over the field of vision. A retinal detachment is a medical emergency. Anyone experiencing the symptoms of a retinal detachment should see an eye care professional immediately.

There are three different types of retinal detachment:

• Rhegmatogenous - A tear or break in the retina causes it to separate from the retinal pigment epithelium (RPE), the pigmented cell layer that nourishes the retina, and fill with fluid. These types of retinal detachments are the most common.
• Tractional - In this type of detachment, scar tissue on the retina's surface contracts and causes it to separate from the RPE. This type of detachment is less common.
• Exudative - Frequently caused by retinal diseases, including inflammatory disorders and injury/trauma to the eye. In this type, fluid leaks into the area underneath the retina (subretina). (Read about "Eye Injury")

Treatment

NEI says small holes and tears can be treated with laser surgery or a freeze treatment called cryopexy. These procedures are usually performed in the doctor's office. During laser surgery, tiny burns are made around the hole to "weld" the retina back to into place. Cryopexy is a similar procedure that freezes the area around the hole.

Retinal detachments can also be treated with surgery that may require the patient to stay in the hospital. In some cases, a scleral buckle, a tiny synthetic band, is attached to the outside of the eyeball to gently push the wall of the eye against the detached retina. If necessary, a vitrectomy may also be performed to treat more severe cases. During a vitrectomy, the doctor makes a tiny incision in the sclera (white of the eye). Next, a small instrument is placed into the eye to remove the vitreous. Salt solution is then injected to into the eye to replace the vitreous.

Early treatment can usually improve the vision of most patients with retinal detachment. Some patients, however, will need more than one procedure to repair the damage.