Retinal detachment | Better Health Channel
Better Health Channel on twitter Connect with us via Twitter and share Australia's best health and medical info with those close to you
Close survey
Retinal detachment

Summary

The retina is the curved, back layer of the eye. It is covered in light-sensitive cells. Retinal detachment means the retina has separated from the back of the eye. Most retinas can be reattached with surgery. Without treatment, blindness may be the result.

Download the PDF version of this fact sheet Email this fact sheet

The retina is the curved, back layer of the eye and is covered in light-sensitive cells that recognise shape, colour and pattern.

When a person has a detached retina, it means the retina has separated from the back of the eye. Without treatment, retinal detachment may worsen until the retina is completely detached and unable to send information down the optic nerve to the brain. This results in blindness. Around one in 10,000 people are affected by some degree of retinal detachment, with older people having a higher risk.

Retinal detachment can only be repaired with surgery. If left untreated, your vision will most likely worsen beyond repair. It is important to see an eye specialist as soon as you experience symptoms.

Retinal detachment surgery involves reattaching the retina to the back of the eye and sealing any breaks or holes. If there is a break or hole in the retina, fluid can collect beneath it and weaken the attachment.

The retina


The retina is the innermost layer of the wall of the eye and is made up of light-sensitive cells known as rods and cones, which detect shape, colour and pattern. The rod-shaped cells respond to dim light, while the cone-shaped cells recognise colour.

The retina is supported on the inside by the jelly-like vitreous, which fills the eyeball behind the lens. On its outer side, the retina is attached to the choroid, or middle layer, which is rich in blood vessels. Nerve fibres leaving the retina bundle together to form the optic nerve.

Light enters the eye through the pupil and is focused by the cornea and the lens so that a crisp picture can fall on the retina. The optic nerve then relays information to the brain.

Symptoms of retinal detachment


The symptoms of retinal detachment include:
Floaters
Blurry vision
Bright lights or sparks, particularly in the periphery (outer edges) of the visual field
Areas of darkness, shadow or shade in the visual field
Loss of vision.

A retinal tear may be accompanied by the sensation of flashing lights in the affected eye. If there is bleeding into the vitreous gel, there may also be showers of dark ‘floaters’ and blurred vision. As the retina detaches, it often causes a dark shadow – like a curtain or veil – in the peripheral vision, which usually progresses to complete vision loss.

See your doctor or eye specialist immediately if you experience any of these visual disturbances. A retinal detachment needs prompt corrective surgery to prevent permanent damage to your eyesight.

Causes of retinal detachment


Retinal detachment is caused by small tears or splits in the retina that allow fluid inside the eye to seep through and separate the retina from its underlying tissue. The most common cause of retinal tears is the shrinking of the vitreous, the thick and jelly-like substance that fills the eyeball and keeps it firm. As the vitreous retracts, it can pull the retina away from the back of the eye.

Small beads of blood may be experienced as a fresh batch of floaters. However, a large tear may lead to a complete and sudden loss of vision. Less commonly, little splits may be the result of eye injury or inflammation.

Near-sighted people, those who have had cataract surgery and anyone who has had a severe eye injury are at higher risk of retinal breaks, but the most common cause is age-related shrinkage of the vitreous gel, which may lead to tearing at a weak point in the retina.

Once a tear or hole develops in the retina, fluid can collect underneath it and start to separate the retina from the choroid, resulting in a detachment. When this happens, the retina can no longer function and vision is lost.

The effect on eyesight depends on the location and severity of the detachment. For example, if the retina detaches at its centre (macula), the person may lose their central vision.

Risk factors for retinal detachment


Some people are more likely than others to experience retinal detachment. Risk factors include:
Family history of the condition
Short-sightedness
Prior eye surgery, such as cataract surgery
Eye injury
Advancing age
Prior retinal detachment in the other eye.

Complications of retinal detachment


If left untreated, the retinal detachment can permanently affect the person’s vision or lead to blindness. Other possible complications include:
Bleeding into the eyeball (which will cloud the vitreous)
Build-up of pressure inside the eyeball
Cataract formation.

Diagnosis of retinal detachment


Retinal detachment is diagnosed using a range of eye tests, including:
Vision tests
Examination of the retina
Ultrasound scan.

Treatment for retinal tears


Treatment options to close up retinal tears and prevent retinal detachment may include:
Photocoagulation – laser surgery. A laser is used to seal the tears by burning the retina. This makes scar tissue form. A scar helps to anchor the retina to the back of the eye
Cryopexy – ‘freeze’ treatment. A small, extremely cold instrument called a cryoprobe prompts the retina to produce scar tissue. This tissue seals the tear, and helps to anchor the retina to the back of the eye.

Surgical procedures for retinal detachment


There are various methods available to reattach the retina, including:
Pneumatic retinoplexy – this is the simplest repair of a detachment, but it is not suitable for everyone. The retinal surgeon injects a gas bubble into the vitreous cavity and treats the tear(s) with either laser or cryotherapy (freezing). The bubble presses the retina flat against the wall of the eye and the laser or freezing sticks the retina down. For this to happen, it is important you follow the surgeon’s instructions about keeping your head in the correct position after the surgery. The gas gradually disappears over the days or weeks following the surgery
Scleral buckling – the surgeon treats the retinal tear with cryotherapy. Then the surgeon drains the fluid under the retina and sutures (sews) a specially shaped piece of silicone rubber to the outer wall of the eye (the sclera). The silicone creates an indent, which closes the tear and holds it in place while the cryotherapy seal has time to form. The scleral buckle is permanent
Vitrectomy surgery – under an operating microscope, the surgeon removes the vitreous using very fine instruments. They treat any tears with laser or cryotherapy and fill the eye with gas or silicone oil. It is important to follow instructions about post-operative head positioning to allow the retina to stick down. You will experience temporary poor vision while your eye is filled with gas. However, if the surgery is successful, your vision will improve as the gas reabsorbs and is replaced with your eye’s own clear fluid. If your eye is filled with silicone oil, you will still be able to see, although the image will tend to be out of focus. Silicone oil is usually removed after a few months. Occasionally, the retinal surgeon may decide to leave it in your eye indefinitely.

Immediately after surgery for retinal detachment


After the operation, you can expect:
Your eye will be covered with an eye pad and perhaps a protective eye shield.
You may need to stay in hospital overnight or, occasionally, for longer.

Self-care after surgery for retinal detachment


Be guided by your surgeon, but general suggestions for care of your eye after the operation include:
Your eye may be sore for several weeks, although this is less likely following a vitrectomy, in which modern fine-gauge instruments are used.
Your vision will be blurry – it may take some weeks, or even three to six months, for your vision to improve.
Your eye may water.
Expect a ‘gritty’ feeling on the surface of your eye if stitches have been used.
Avoid rubbing or pressing on your eye.
You may need to wear an eye pad for protection at night while your eye is healing.
Be sure to follow all directions for medications, such as eye drops.
Avoid vigorous activity for some weeks following surgery.
Obey all instructions on head positioning.
See your surgeon immediately if you experience severe pain.

Complications of surgery for retinal detachment


Risks and complications depend on the procedure used, but can include:
The formation of cataracts (loss of clarity of the lens of the eye)
Glaucoma (raised pressure in the eye)
Infection
Haemorrhage (bleeding) into the vitreous cavity
Vision loss
Loss of the eye, although modern surgical techniques make this very unlikely.

Long-term outlook after surgery for retinal detachment


In most specialist centres, around nine out of 10 retinal detachments are successfully repaired with a single operation. In the remaining cases, the retina detaches again and needs another operation. The final success rate is over 95 per cent. After treatment, your vision may improve over the next few months, but often some vision loss is permanent. Usually, you will need a change of prescription glasses.

Whether or not your vision returns depends not only on the success or failure of the operation, but also on the duration, extent and location of the detachment. For example, if your macula (the part of the retina responsible for central vision) has detached, it is unlikely that your full vision will ever return, even if the operation is successful.

Where to get help


Your doctor
Eye specialist
Retinal surgeon
Royal Victorian Eye and Ear Hospital Tel. (03) 9929 8666

Things to remember


The retina is the curved back layer of the eye and is covered in light-sensitive cells.
Retinal detachment means the retina has separated from the back of the eye.
Retinal detachment surgery involves reattaching the retina to the back of the eye and sealing any breaks or holes in the retina.
The treatment success rate is high, with around nine out of 10 retinas able to be reattached.
Older people are at higher risk of retinal detachment.
If left untreated, a detached retina can cause permanent damage to your eyesight.

You might also be interested in:

Want to know more?

Go to More information for support groups, related links and references.


This page has been produced in consultation with and approved by:

Centre for Eye Research Australia

(Logo links to further information)


Centre for Eye Research Australia

Fact sheet currently being reviewed.
Last reviewed: September 2011

Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your doctor or other registered health professional. Content has been prepared for Victorian residents and wider Australian audiences, and was accurate at the time of publication. Readers should note that, over time, currency and completeness of the information may change. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions.


If you would like to link to this fact sheet on your website, simply copy the code below and add it to your page:

<a href="http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Retinal_detachment?open">Retinal detachment - Better Health Channel</a><br/>
The retina is the curved, back layer of the eye. It is covered in light-sensitive cells. Retinal detachment means the retina has separated from the back of the eye. Most retinas can be reattached with surgery. Without treatment, blindness may be the result.



Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your qualified health professional. Content has been prepared for Victorian residence and wider Australian audiences, and was accurate at the time of publication. Readers should note that over time currency and completeness of the information may change. All users are urged to always seek advice from a qualified health care professional for diagnosis and answers to their medical questions.

For the latest updates and more information, visit www.betterhealth.vic.gov.au

Copyight © 1999/2014  State of Victoria. Reproduced from the Better Health Channel (www.betterhealth.vic.gov.au) at no cost with permission of the Victorian Minister for Health. Unauthorised reproduction and other uses comprised in the copyright are prohibited without permission.

footer image for printing