When the retina separates from its underlying tissue, the visual consequences can be quite serious. If the problem is not corrected, it can cause irreversible vision loss. Eye doctors known as retina specialists are specially trained in the evaluation and treatment of problems like retinal detachment. They complete years of education and training designed to prepare them for complex cases that threaten vision. With prompt attention, a retina specialist can repair the detached retina and increase a person’s chances of full visual recovery.
What Causes the Retina to Detach?
The retina is the layer of light-sensitive tissue that lines of the back of the eye. The middle of the eye is filled with vitreous, a clear, jelly-like material that attaches to the retina. Typically, the vitreous moves within the eye without causing any harm. However, with age, the vitreous can shrink and start to pull on pieces of the retina, causing a tear. Then, more vitreous fluid can leak through the space between the retina and the back of the eye and may lift the retina off the back of the eye. This is known as retinal detachment. Sometimes age is not the problem — swelling in the eye or nearsightedness can cause the vitreous to pull on the retina and lead to retinal detachment.
Symptoms of a Detached Retina
Two primary symptoms of retinal detachment are the sudden appearance of flashes and the sudden increase in size and number of floaters. Flashes are visual disturbances that look like flashing lights, lightening streaks or stars. They occur when the vitreous fluid shrinks and pulls on the retina. Floaters are small clumps of cells or vitreous gel that cast shadows on the retina; they resemble tiny specks, dots, strings or clouds.
Other symptoms include:
- Shadows in a person’s peripheral (side) vision
- A gray curtain-like shadow coming down from the visual field
- Sudden decrease in vision
People with retinal detachment do not experience any pain.
A detached retina can be diagnosed by an ophthalmologist during a dilated eye exam. Ultrasound imaging may help provide a clearer picture of the retina. The ophthalmologist can determine whether the retina has detached or torn, and recommend suitable treatment options.
Retinal detachments can lead to permanent vision loss over a relatively short time period as more retinal tissue pulls away from the back of the eye. Treatments for retinal detachment are often performed on an emergency basis to prevent short-term advancement of this serious eye health problem.
There are a few ways to surgically reposition the retina back in its proper place. One option is to place a small, flexible band called a scleral buckle around the eye. By putting slight inward compression on the eye, the band offsets the force pulling the retina out of place. This allows the retina to reattach to the back of the eye. The band is made of silicone or plastic materials and is invisible after surgery.
In some cases, the scleral buckle is combined with a vitrectomy, in which vitreous fluid is removed from the back of the eye. Clear silicone oil or a gas bubble replaces the vitreous to coax the retina back into place. A gas bubble is naturally replaced with the body’s own fluids over time; an oil bubble needs to be removed during a later procedure.
Another treatment option is pneumatic retinopexy, which involves injecting a gas bubble into the vitreous space to push the detached portion of the retina back into place. With the gas bubble, the patient may need to hold their head in a certain position for several days, and refrain from flying or traveling at high altitudes until the gas bubble naturally disappears on its own.
Experiencing a Sudden Onset of Floaters or Flashes?
Are you experiencing troubling visual symptoms like floaters or flashes? Would you like to be examined and evaluated by an experienced ophthalmologist? Please contact our practice — specializing in the diagnosis, treatment and management of retinal diseases — and request a consultation.