Retinal detachment

Detached Retina – Symptoms, Causes and Treatment

Detached retina is the separation of the inner layer of the retina – the nerve tissue’s thin membrane lining the back of the eye – from the eye wall. It may lead to permanent vision loss if not treated urgently.

Indications of Detached Retina

Retinal detachment may result in warning signs that can be gradual or immediate.

  • Sudden flashes of lights, spots and floaters
  • Blurry or poor vision
  • Seeing a ‘curtain-like’ shadow to one side or the other
  • Seeing a vertical ‘window-blind’ movement - up or down

It was reported in the Journal of the American Medical Association (2009) that retinal tear or detachment is likely to occur in 1 in 7 people who experience sudden flashes and floaters. Detachment ensues in about half of all retinal tear cases.

Retinal detachment is painless. The warning signs should prompt an immediate visit to an eye doctor to preventing blindness.

Causes of Retinal Detachment

  • Spontaneous, with no obvious cause
  • Eye injury, eye disease, tumor
  • Sicknesses such diabetes and sickle cell disease
  • Diabetic retinopathy and other new blood vessel growths in the retina
  • High Myopia i.e. extreme nearsightedness (due to longer eyeballs that make the retina thinner)
  • LASIK surgery (a rare occurrence where 4 in 1,500 patients, whose pre-LASIK prescription range was from 8.00 D to 27.50 D, suffered retinal detachment)
  • Complicated cataract surgery
  • Various fluid movements in the eyes

Retinal detachment has affected people in many different fields. Among those who suffered from detached retina that was publicly reported include Joseph Pulitzer. The newspaper empire of this famous journalist, publisher and politician continued to flourish despite the condition. He went completely blind in his 40s.

Eye injury among athletes is common and sometimes results in a detached retina. Basketball player Amar’e Stoudemire advocated the use of sports goggles after he underwent retina-corrective surgery as a result of several eye injuries from the sport he played. Other players with detached retina include Pelé (soccer), Sugar Ray Leonard (boxing), Alicia Alonso (ballet) and Alan Belcher (mixed martial arts).

Former U.S. President Theodore Roosevelt who was also was a boxer reportedly suffered from partial blindness in the left eye after a punch landed on his head. The American Academy of Ophthalmology stated that Roosevelt’s vision loss may have been due to a detached retina.

Protective eyewear can help prevent the occurrence of detached retina. If you sustain an eye injury always seek immediate medical care to prevent blindness.

Detached Retina Treatment

A retinal specialist (an ophthalmologist with advanced retinal training) can perform corrective surgery, a procedure required to repair a detached retina. The chance of restoring the vision is higher the sooner the retina is reattached.

Scleral buckling surgery

A small band of silicone or plastic is attached to the sclera (the outside the globe) to press the eye inward so the retina reattaches to the interior wall. The scleral buckle is attached to the eye’s posterior portion.

To further strengthen the reattachment to the RPE (retinal pigment epithelium) – the core supporting tissue – the surgery is often combined with the following:

  • Vitrectomy   – the removal of the clear jelly-like fluid from the posterior chamber of      the eye (vitreous body). It is substituted with clear silicone oil which pressures the detached portion of the retina back onto the RPE.
  • Pneumatic retinopexy – a small gas bubble is injected into the vitreous body, pushing the detached retina portion onto the RPE.

If the retinal detachment is due to a tear, laser (laser photocoagulation) or a freezing probe (cryopexy) is used to bond the retina firmly onto the RPE and the core tissues, sealing the tear in the process.

The success of surgical reattachment may depend on numerous factors including the extent of detachment, the cause and its position. Normal or better vision is not always guaranteed after the reattachment unless the damage is confined within the peripheral retina and the macula (central part of retina) is intact.