OasisEye Specialists

Retinal Detachment

What is Retinal Detachment?

Retinal detachment is a sight-threatening eye emergency that occurs when the retina which the light-sensitive tissue lining the back of the eye, separates from its underlying support tissue. Without prompt treatment, the retina can lose its blood supply, leading to permanent vision loss.

Retinal detachment often begins with a retinal tear, allowing fluid to collect beneath the retina and cause it to peel away. Early diagnosis and timely treatment by a retinal specialist offer the best chance of preserving vision and preventing blindness. People with high myopia, previous eye surgery, eye injuries, or certain retinal conditions have a higher risk of developing retinal detachment.

Retinal Detachment explained by Dr Kenneth Fong Choong Sian

Retinal Hole Causes Retinal Detachment

The vitreous is a transparent jelly like structure inside the eye that is attached to the retina. As you get older, this vitreous jelly degenerates and pulls away from the retina. Sometimes, this can cause a hole in the retina. The hole allows fluid to enter underneath the retina and causes it to detach. This is like wallpaper coming off the wall when it is loose. Most eye doctors would treat the retinal hole with laser to prevent development of retinal detachment.

Risk Factor of Retinal Detachment

Retinal detachment occurs in less than 1 in 10000 people.

  1. More common in people with myopia
  2. Who have had previous eye trauma
  3. Complicated cataract surgery
  4. More common in the older age group compared to children.

What are the symptoms of retinal detachment?

Retinal detachment is usually painless, but it often causes sudden visual symptoms that should never be ignored. Common warning signs include:

  • A sudden increase in floaters
  • Flashes of light, especially in your side vision
  • A dark curtain or shadow moving across your vision
  • Blurred or distorted vision
  • Sudden loss of peripheral (side) vision

If you notice any of these symptoms, seek emergency eye care immediately. Prompt diagnosis and treatment can significantly improve the chances of saving your vision.

When should you seek emergency treatment?

Retinal detachment is an eye emergency. You should see an ophthalmologist immediately or visit the nearest emergency department if you experience:

  • A sudden shower of new floaters
  • Repeated flashes of light
  • A dark curtain or shadow
  • over part of your vision
  • Sudden blurred vision
  • Sudden loss of side vision

Delaying treatment may reduce the likelihood of restoring useful vision, particularly if the macula becomes detached.

Diagnosis of Retinal Detachment

The diagnosis can be made by an eye doctor who examines the back of your eye with an ophthalmoscope. There are no specific tests for retinal detachment. The diagnosis is quite straightforward and there is usually no doubt about it.

Treatment for Retinal Detachment

Treatment When is it used? Main goal
Laser photocoagulation Retinal tear without detachment Seal the retinal tear and prevent detachment
Cryotherapy Selected retinal tears Create scar tissue to secure the retina
Pneumatic retinopexy Suitable uncomplicated detachments Reattach the retina using a gas bubble
Scleral buckle surgery Certain retinal detachments Support the eye wall and close retinal breaks
Vitrectomy Complex retinal detachments or vitreous traction Remove vitreous gel, repair retinal tears, and reattach the retina

Retinal Surgery

Another way to treat retinal detachment is by suturing a piece of silicone called a scleral buckle to the outside of the eye and treating the retinal hole with freezing treatment called cryotherapy. This procedure is widely known as “Cryo-buckle”. The scleral buckle can also be combined with vitrectomy in more complicated retinal detachments. This buckle presses the eyeball inwards to help close the retinal hole. Surgery for retinal detachment is quite successful and we can reattach the retina 90% of the time with one operation. Sometimes, further surgery is required if the retina comes off again. Patients often have to posture face down after surgery to allow the gas bubble to come into direct contact with the retina. Your retinal specialist will tell you how to posture and for how often. The gas bubble in the eye normally dissolves by itself after 1 month. You should not travel in an aeroplane if you have gas in the eye. This is because the gas bubble will expand at high altitude and cause very high pressure in the eye. If you have silicone oil injected into the eye, this oil will have to be removed after 6 months with a second operation. In summary, if you have any symptoms of retinal detachment, you should seek expert advice from a retinal surgeon and have surgery as soon as possible if you do have such a problem. Do not delay treatment as it may result in permanent loss of vision. If retinal detachment surgery is done before the detachment involves the macula, you can normally retain your vision as before. Retinal detachment cannot be prevented by diet or supplements. People who are very myopic (more than -6.0 dioptes of power) are at much higher risk of developing a detachment than the rest of the population.

FREQUENTLY ASKED QUESTIONS

Retinal detachment is an eye emergency in which the retina separates from the back of the eye. Without prompt treatment, the detached retina can lose its blood supply, leading to permanent vision loss. Early diagnosis and surgery offer the best chance of preserving vision.

Common warning signs include a sudden increase in floaters, flashes of light, a dark curtain or shadow moving across your vision, blurred vision, or sudden loss of side vision. These symptoms require urgent assessment by an ophthalmologist.

Yes. Retinal detachment is a medical emergency. The sooner treatment is performed, particularly before the macula becomes detached, the greater the chance of preserving useful vision.

Retinal detachment most commonly occurs when a retinal tear allows fluid to collect beneath the retina. Risk factors include ageing, high myopia (short-sightedness), previous eye surgery, eye injury, and certain retinal conditions.

You may have a higher risk if you are highly short-sighted, have had cataract surgery, experienced an eye injury, have a family history of retinal detachment, or have previously had a retinal tear or detachment in the other eye.

Yes. Retinal detachment is usually painless. Many people notice only visual symptoms such as flashes, floaters, blurred vision or a shadow over their vision.

No. A retinal detachment does not heal without treatment. Surgery is usually required to reattach the retina and reduce the risk of permanent vision loss.

Treatment depends on the type and severity of the detachment and may include laser photocoagulation, cryotherapy, pneumatic retinopexy, scleral buckle surgery, or vitrectomy. Your retinal specialist will recommend the most appropriate option for your condition.

In many cases, the retina can be successfully reattached with a single operation. However, some patients may require additional procedures if the retina detaches again or complications develop.

Recovery varies depending on the type of surgery and the severity of the detachment. Vision may continue improving over several weeks to months, although some patients may not regain their previous level of vision, especially if the macula was affected.

If a gas bubble has been placed inside your eye during surgery, you should not fly or travel to high altitudes until your ophthalmologist confirms that the gas has completely dissolved. Flying with an intraocular gas bubble can cause a dangerous rise in eye pressure.

A retinal tear is a break in the retina, while retinal detachment occurs when the retina separates from the back of the eye. Treating a retinal tear early with laser or cryotherapy may help prevent retinal detachment.

Seek urgent medical attention immediately if you experience a sudden shower of floaters, flashes of light, a curtain-like shadow across your vision, sudden blurred vision, or partial vision loss. Early treatment can make a significant difference to your visual outcome.