Retinal Detachment

By Judith Lee and Gretchyn Bailey; reviewed by Vance Thompson, MD

A retinal detachment is a serious and sight-threatening event, occurring when the retina becomes separated from its underlying supportive tissue. The retina cannot function when these layers are detached, and unless it is reattached soon, permanent vision loss may result.

Retinal Detachment Symptoms and Signs

If you suddenly notice spots, floaters and flashes of light, you may be experiencing the warning signs of retinal detachment. Your vision might become blurry, or you might have poor vision. Another sign is seeing a shadow or a curtain coming down from the top of the eye or across from the side. These signs can occur gradually as the retina pulls away from the supportive tissue, or they may occur suddenly if the retina detaches immediately.

There is no pain associated with retinal detachment. If you experience any of the signs, consult your eye doctor right away. Immediate treatment increases your odds of regaining lost vision.

What Causes Retinal Detachments?

An injury to the eye or face can cause a detached retina, as can very high levels of nearsightedness. Extremely nearsighted people have longer eyeballs with thinner retinas that are more prone to detaching.

On rare occasions, retinal detachment may occur after LASIK surgery in highly nearsighted individuals. In a study of more than 1,500 LASIK patients, just four suffered retinal detachment; their pre-LASIK prescriptions ranged from -8.00 D to -27.50 D.

Cataract surgery, tumors, eye disease and systemic diseases such as diabetes and sickle cell disease may also cause retinal detachments. New blood vessels growing under the retina — which can happen in diseases such as diabetic retinopathy — may push the retina away from its support network as well. Sometimes fluid movement in the eye pulls the retina away.

Treatment for Retinal Detachment

An eye surgeon must reattach a detached retina. Laser photocoagulation, a method of sealing off leaking blood vessels and destroying new blood vessel growth with a laser beam, is another way to reattach the retina.

Seeing a shadow coming down across your field of vision is a sign of retinal detachment.

Some ophthalmologists inject silicone oil into the eye to keep the detached retina in place. A similar treatment is pneumatic retinopexy, in which a bubble of gas is injected into the vitreous humor, the transparent gel filling the eyeball in front of the retina. The gas bubble expands and presses against the retina to hold it against its supportive tissue. Cryotherapy (freezing) or photocoagulation will then permanently reattach the retina.

Sometimes vision lost by a retinal detachment will come back after treatment. The sooner the retina is reattached, the better the chances of regaining vision.

Occasionally the retina tears a small amount or contains holes, especially in highly nearsighted people. These tears or holes don't necessarily demand treatment right away. Your eye doctor will monitor these retinal defects at each visit. Retinal holes can be repaired with laser photocoagulation.

[Page updated June 2007]