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. When the retina detaches, it is lifted or pulled from its normal position. Retinal detachment can cause permanent vision loss. Retinal tears or retinal breaks are small areas of the retina that are torn. These areas can lead to retinal detachment.
The vitreous fluid shrinks as we age. This is a normal process that usually does not cause retinal damage. However, inflammation or myopia (near-sightedness) may cause the vitreous to pull away and can lead to a detached retina.
Increased risk of retinal tears and detachment includes:
Retinal detachment itself is painless. If part of the retina detaches, it will not function properly. But warning signs almost always appear before it occurs or has advanced, such as:
It is important that you see an eye doctor right away. Your doctor needs to act quickly to try to repair the damage and prevent permanent vision loss.
A detached retina cannot be seen from the outside of the eye. The only way to diagnose retinal tears is through a comprehensive eye examination. Your eye doctor will use a lighted magnification instrument to view the inside of your eye. Other diagnostic instruments include certain types of contact lenses, a slit lamp or ultrasound.
If your retina is only torn, prompt treatment may prevent detachment. The type of procedure recommended will depend on several factors, including how severe it is. There are a number of options available:
Laser photocoagulation: Helpful in repairing small retinal tears, the laser creates small burns around the edges of the tear, which produces scars. These scars seal the borders of the tear and prevent fluids from leaking toward the retina, which helps to avoid detachment.
Cryopexy: The use of extreme cold to cause scar formation and seal the edges of a retinal tear.
Liquid silicone: Injected to replace the vitreous fluid to maintain the normal shape of the eye and hold the retina and eye wall in alignment. To repair actual retinal detachments, fluid must be drained from under the retina to minimise the space between it and the eye wall. A silicone band may be used on the outside of the eye to push the back wall against the retina.
Patient with retina detachment will need surgery to repair it. The type of surgery recommended will depend on several factors, including how severe the detachment is. Treatments include:
Pneumatic retinopexy (injecting air or gas into the eye): Doctor injects a bubble of air or gas into the centre part of the eye. The bubble pushes the area of the retina containing the hole or holes against the wall of the eye, stopping flow of fluid into the space behind the retina. Patients may need to hold their head in a certain position for up to several days to keep the bubble in the proper position.
Scleral buckling (indenting the surface of your eye): Doctors will sew (suturing) a piece of silicone material to the white of your eye (sclera) over the affected area. The procedure indents the wall of the eye and relieves some of the force caused by the vitreous tugging on the retina.
Vitrectomy (draining and replacing the fluid in the eye): Doctors remove the vitreous along with any tissue that is tugging on the retina. Air, gas or silicone oil is then injected into the vitreous space to help flatten the retina. Eventually the air, gas or liquid will be absorbed, and the vitreous space will refill with body fluid.
Liquid silicone: Injected to replace the vitreous fluid to maintain the normal shape of the eye and hold the retina and eye wall in alignment. To repair actual retinal detachments, fluid must be drained from under the retina to minimise the space between it and the eye wall. A silicone band may be used on the outside of the eye to push the back wall against the retina.
Click here to access our Find A Doctor directory for a list of doctors treating this condition across our NUHS institutions.
