Retinal Detachment

 

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What is retinal detachment?

A retinal detchment is a condition where the retina at the back of the eye "detaches" from its normal position. An analogy is of wallpaper stripping off a wall. If we imagine the eye to function in a similar way as a camera, the retina represents the "film" at the back. Images strike the retina which then sends the images to the brain for processing, which results in what we know as the sense of sight. If the retina is not in the correct position, it will not function properly and sight will be affected. 

The most common mechanism for retinal detachment is related to the vitreous (sometimes referred to as vitreous gel) at the back of the eye. The vitreous fills the cavity at the back of the eye, and is normally attached to the retina. If the vitreous detaches from the back of the eye, it can pull on the retina and cause a retinal tear. This tear can then proceed to cause the retina to detach, and move away from its normal position. The causes for the vitreous to detach are unknown, but risk factors including getting older, being short-sighted (myopic) and trauma (physical injury).

What are the symptoms?

Symptoms commonly reported relating to the vitreous detaching are flashing lights and floaters. Those having a retinal tear also often report these, as the mechanism is the same in both. If a tear proceeds to a retinal detachment, in addition to experiencing flashing lights and floaters, patients often experience a shadow in their vision. This shadow corresponds to where the retina has detached and serves as a good clue as to which part of the retina (e.g. the upper or lower) has detached. Finally, the patient with a retinal detachment may also experience loss of central vision. This is an important sign, as it often indicates the retina has detached in the centre (the centre of the retina is called the macula).

How is it treated?

If a retinal detachment is not treated promptly, it will often lead to permanent visual loss. The degree of how urgent an operation needs to be performed will depend on several factors, the most important of which is whether the centre of the retina (the macula) is still attached or not. If the macula is attached, then prompt surgery may prevent the development of significant visual loss. If however the macula is detached at the time of surgery, whilst the operation can still restore vision to the eye, the ultimate vision that can be achieved will be limited and it is likely that vision may never return to what it once was in that particular eye. However without surgery, the prognosis is very poor and a large number of untreated retinal detachments may go blind in the untreated eye.

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