Detached Retina

Detachment of the retina is a serious problem that can occur at any age without apparent cause. However, it occurs most frequently in "middle-aged" and older individuals. Retinal detachments will affect one out of every ten thousand people each year. It is more likely to develop in people who are nearsighted and those whose relatives have had detachments or a history of detachment in the other eye. If not treated early, retinal detachments may lead to impairment or loss of vision.

The retina is a thin transparent tissue of light-sensitive nerve fibers and cells. It covers the inside wall of the eye like wallpaper covers the walls of a room. The retina functions like film in a camera. Light passes through the lens of the eye and is focused onto the retina. These images are then transmitted by the optic nerve to the brain.

Causes and Symptoms

Most retinal detachments are caused by the presence of one or more small holes or tears in the retina. Normal aging can sometimes cause the retina to thin and deteriorate and sometimes tear. The vitreous gel that lies between the lens and the retina fills the center of the eye and is frequently responsible for retinal tears. The vitreous is firmly attached to the retina in several places on the back wall of the eye. As it shrinks, it may pull a piece of the retina away with it, thus leaving a hole or tear in the retina. Shrinking of the vitreous or changes in its form is a natural aging process and usually causes no damage to the retina. Once a retinal tear or hole is present, water fluid from the vitreous space may pass through the hole and flow back under the retina and cause a retinal detachment.

It should also be noted that there are some retinal detachments that are caused by other diseases in the eye such as tumors, inflammation and diabetic complications. These secondary detachments do not have breaks in the retina and cannot be treated in the same fashion. Successful surgical treatment of a retinal detachment will place the retina back in its proper place.

It is not uncommon to see floating black spots or "floaters" and flashes of light. These are usually less common in children or young adults but can happen at any age. In most cases, these symptoms do not indicate serious problems; however, in some cases, the sudden appearance of spots or flashes may indicate substantial shrinkage of the vitreous and tearing of the retina. A complete eye examination with dilation is necessary to check the inside of the eye to determine if a retinal break is present. Retinal breaks should be followed closely and treated at the appropriate time to prevent any retinal detachments.

Some retinal detachments may begin without noticeable floaters or light flashes. In these instances, patients may notice wavy, watery quality in their overall vision or the appearance of a dark shadow in part of their vision. As the retinal detachment progresses, central vision will blur, creating significant visual loss in one eye

Over 90 percent of all retinal detachments can be corrected by modern surgical technique. Occasionally, more than one operation is required. Unfortunately, a small number of cases have continued shrinkage of the vitreous. Development of fibrous growths on the retina makes it impossible to re-attach the retina and save the sight.

As with all ocular conditions, early diagnosis and treatment improves the chance of success. Patients with symptoms of retinal detachment should promptly contact our office. It is important for persons with significant myopia, nearsightedness or family histories of retinal detachment to have periodic eye exams, so that early detection of changes in the eye can be diagnosed and possibly prevent further deterioration.