What is the retina?
Imagine that your eye is like a camera, and the retina is the film. The retina is a fine sheet of nerve tissue lining the inside of the eye (see diagram). Rays of light enter the eye and are focused on the retina by the lens. The retina produces a picture which is sent along the optic nerve for the brain to interpret. It's rather like the film in the camera being developed so that pictures can be produced
What is retinal detachment?
Usually the retina is attached to the inner surface of the eye. If there is a tear or hole in the retina then fluid can get underneath it. This weakens the attachment so that the retina becomes detached - rather like wallpaper peeling off a damp wall.
When this happens the retina cannot compose a clear picture from the incoming rays and your vision becomes blurred and dim.
Who is more likely to get it?
Detachment of the retina happens more to middle aged, short sighted people. It is quite uncommon however and only about one person in ten thousand is affected.
Very rarely, younger people can have a weakness of the retina.
What are the symptoms?
The most common symptom is a shadow spreading across the vision of one eye. You may also experience bright flashes of light and/or showers of dark spots called floaters. These symptoms are never painful.
Many people experience flashes or floaters and these are not necessarily a cause for alarm. However if they are severe and seem to be getting worse, and/or you are losing vision then you should see a doctor urgently. Prompt treatment can often minimise the damage to your eye.
What is the treatment?
If you get help early, it may only be necessary to have a laser or freezing treatment. This is usually performed under a local anaesthetic.
Often however, an operation to repair the hole in the retina will be needed. This is usually done under a general anaesthetic and can be repaired with a single operation in 90 per cent of cases. This does not usually cause much pain but your eye will be sore and swollen for a few days afterwards. You will usually need to stay in hospital for two or three days after your operation.
We want to reassure you that your surgeon does not take your eye out of its socket to operate on it.
How much vision can I expect after a successful operation?
This depends on how much the retina has detached and for how long.
The shadow caused by the detachment will disappear in all cases when the retina has been put back in place. However, if the detachment involves the part of the retina which is responsible for your central vision, this may not recover. The longer this part of the retina has been detached, the smaller the chance that your central vision will recover to its former level. But, if this is the case, you will still have some useful vision left.
What happens after the operation?
Usually you can return home after two or three days in hospital. And you will be encouraged to get up and carry on as usual on the day after the operation. Sometimes you will be asked to keep your head in a particular position to help the healing process.
You can resume normal activities, including sex, as soon as you feel able.
What happens if the retina is not put back in place?
Most people will lose all useful vision if no operation is carried out, or if the treatment is unsuccessful. Occasionally, if the detachment involves the lower portion of the retina, some vision may recover by itself.
Can retinal detachment be prevented?
If your family has a history of retinal detachment, or your doctor finds a weakness in your retina then preventive laser or freezing treatment may be needed. In most cases however it is not possible to take preventive action.
Retinal detachment does not happen as a result of
straining your eyes, bending or heavy lifting.
Am I likely to get one in the other eye?
If you have had a retinal detachment in one eye, you are at increased risk of developing one in the other eye. But there is only about a one in ten chance of this happening.
What if my sight cannot be fully restored?
Much can be done to help you use your remaining vision as fully as possible. You should ask your doctor to refer you to the hospital low vision clinic. There are a variety of optical aids such as brighter reading lights, simple magnifying glasses and more sophisticated equipment that can help you. RNIB can also advise you about the help that is available.
What is the retina?
The retina is a thin sheet of light sensitive nerve tissue lining the inside of the eye. It is the tissue that turns light into an electrical signal to send to the brain. It can be compared to the film in a camera.
What is the vitreous?
The vitreous is a jelly-like material that fills most of the space inside the eye. As we age, the vitreous often liquefies and may collapse. When this happens, the vitreous separates from the retina. This can result in the eye seeing flashes and floaters (see section on "Flashes and Floaters"). Vitreous liquefaction and separation are more likely to occur, and occur much earlier, in eyes that are nearsighted. They can also occur after injuries or eye inflammation.
What is a retinal tear?
When the vitreous separates from the retina, in some eyes it may tear the retina. These tears are often small and located near the front of the retina. The only symptoms produced by a retinal tear are flashes and/or floaters.
Anyone with flashes or the sudden onset of a new floater (or floaters) should be examined promptly by an ophthalmologist. The ophthalmologist will search carefully for retinal tears.
What is a retinal detachment?
A retinal detachment is a separation of the retina from the back wall of the eye. When there is a tear of the retina, liquid from the vitreous may pass through the tear, and detach the retina. As the fluid accumulates, the retinal detachment becomes larger. Detached areas of the retina lose their vision.
What are the symptoms of a retina detachment?
Most people notice floaters and flashes before the retina detaches. As the detachment occurs, a gradually enlarging dark area may be seen. Some people have compared this to a curtain coming down, or a shade being drawn in front of the eye. The dark area may begin in any part of the field of vision. If the dark area reaches the center of the field of vision, the eye will not be able to see fine detail.
Who may get a retinal detachment?
Although anyone may get a retinal detachment, they are far more common in some groups. These include nearsighted people, those over 50, those who have had significant eye injuries, and those with a family history of retinal detachments.
How are retinal tears and detachment treated?
Retinal tears with minimal or no detachment may be treated with laser or freezing (cryopexy) procedures. Some retinal tears do not require treatment.
Most of retinal detachment require surgery to reposition the separated retina against the back wall of the eye. There are several methods in use today. The type of surgery used depends on the type and extent of detachment, and the preference of the patient and retina surgeon.
Scleral buckling is the most common operation for a detached retina. In this procedure, the causative retinal tear or tears are located and treated. A flexible piece of rubber is then sewn to the sclera (white of the eye) to support the area of tears and detachment. Fluid may be drained from under the detached retina.
Pneumatic retinopexy is a newer method for retinal detachment repair. It is not suitable for all types of detachment. In this technique, the causative tear or tears are identified and treated. A bubble of a special gas is then injected into the eye. The gas is used to push against the area of the retinal tear(s).
Vitrectomy is another surgical method to treat some types of retinal detachment. It is usually used for detachments with unusual or difficult features, such as very large tears, scar tissue on the retina, excessive blood in the vitreous, or detachments that failed by other methods.
What happens after the operation?
Usually you can return home after two or three days in hospital. And you will be encouraged to get up and carry on as usual on the day after the operation
Because the detachment may damage the retina, most people do not get back perfect vision.
If the macula (the central, most sensitive part of the retina) was not affected by the detachment, about 2 out of 3 eyes will get back reading vision. If this area was affected, only about 1 out of 3 eyes will get back reading vision.
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