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Retinal Detachment
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Rosa Y. Kim, MD
John I. Loewenstein, MD
Massachusetts Eye and Ear Infirmary, Harvard Medical School
October 15, 2002

What is the retina?
The retina is a thin sheet of light sensitive nerve tissue lining the inside of the eye. It is the tissue that turns light INTO an electrical signal to send to the brain. It can be compared to the film in a camera.

What is the vitreous?
The vitreous is a jelly-like material that fills most of the space inside the eye. As we age, the vitreous often liquefies and may collapse. When this happens, the vitreous separates FROM the retina. This can result in the eye seeing flashes and floaters (see section on "Flashes and Floaters"). Vitreous liquefaction and separation are more likely to occur, and occur much earlier, in eyes that are nearsighted. They can also occur after injuries or eye inflammation.

What is a retinal tear?
When the vitreous separates FROM the retina, in some eyes it may tear the retina. These tears are often small and located near the front of the retina. The only symptoms produced by a retinal tear are flashes and/or floaters.

Anyone with flashes or the sudden onset of a new floater (or floaters) should be examined promptly by an ophthalmologist. The ophthalmologist will search carefully for retinal tears.

What is a retinal detachment?
A retinal detachment is a separation of the retina FROM the back wall of the eye. When there is a tear of the retina, liquid FROM the vitreous may pass through the tear, and detach the retina. As the fluid accumulates, the retinal detachment becomes larger. Detached areas of the retina lose their vision.

What are the symptoms of a retina detachment?
Most people notice floaters and flashes before the retina detaches. As the detachment occurs, a gradually enlarging dark area may be seen. Some people have compared this to a curtain coming down, or a shade being drawn in front of the eye. The dark area may begin in any part of the field of vision. If the dark area reaches the center of the field of vision, the eye will not be able to see fine detail.

Who may get a retinal detachment?
Although anyone may get a retinal detachment, they are far more common in some groups. These include nearsighted people, those over 50, those who have had significant eye injuries, and those with a family history of retinal detachments.

How are retinal tears and detachment treated?
Retinal tears with minimal or no detachment may be treated with laser or freezing (cryopexy) procedures. Some retinal tears do not require treatment.

Most of retinal detachment require surgery to reposition the separated retina against the back wall of the eye. There are several methods in use today. The type of surgery used depends on the type and extent of detachment, and the preference of the patient and retina surgeon.

Scleral buckling is the most common operation for a detached retina. In this procedure, the causative retinal tear or tears are located and treated. A flexible piece of rubber is then sewn to the sclera (white of the eye) to support the area of tears and detachment. Fluid may be drained FROM under the detached retina.

Pneumatic retinopexy is a newer method for retinal detachment repair. It is not suitable for all types of detachment. In this technique, the causative tear or tears are identified and treated. A bubble of a special gas is then injected INTO the eye. The gas is used to push against the area of the retinal tear(s).

Vitrectomy is another surgical method to treat some types of retinal detachment. It is usually used for detachments with unusual or difficult features, such as very large tears, scar tissue on the retina, excessive blood in the vitreous, or detachments that failed by other methods.

Will I get my vision back if I have detached retina?
With current methods, about 9 out of 10 retina detachments can be repaired. Because the detachment may damage the retina, most people do not get back perfect vision.

If the macula (the central, most sensitive part of the retina) was not affected by the detachment, about 2 out of 3 eyes will get back reading vision. If this area was affected, only about 1 out of 3 eyes will get back reading vision.

The information and recommendations appearing on these pages are informational only and is not intended to be a basis for diagnosis, treatment or any other clinical application. For specific information concerning your personal medical condition, the DJO suggests that you consult your physician.