Retinal Tears & Detachments

What is the Retina?

In order to see, light passes into the eye and is focused onto a layer at the back called the retina. The retina is a thin nerve layer that detects the light and sends the message to your brain.

What is a Retinal Detachment?

A retinal detachment is when the thin retina layer detaches from the back of the eye. When this occurs, the retina cannot properly detect light, thus making your vision blurry. A retinal detachment is a very serious problem and unless treated, can cause blindness.

What Causes Retinal Detachments?

Your eye is filled with a clear gel-like substance called vitreous. As we age, the vitreous shrinks and pulls on your retina. In some cases, the vitreous separates from the retina without causing any problems but in more serious cases, it tugs on the retina and leads to a detachment.

Conditions that increase the chances of a retinal detachment:

• Nearsightedness
• Cataract surgery
• Glaucoma
• Severe injury
• Previous retinal detachments
• Family history of retinal detachment
• Weak areas in your retina

Warning Signs

A retinal detachment may be present if you experience any of these symptoms:

• Flashing lights
• Floaters
• A shadow in the periphery of your vision
• A gray curtain moving across your vision

Experiencing any of these symptoms does not necessarily mean you have a retinal detachment – the symptoms could indicate something less serious. However, it is important to have your eyes examined by your ophthalmologist as soon as possible.

Retinal Tears

To prevent a sight threatening retinal detachment, a retinal tear should be treated with laser surgery or cryotherapy (freezing). Performed in your ophthalmologist’s office, these procedures seal the retina onto the back of the eye with little to no discomfort.

Retinal Detachment

Patients with a retinal detachment require surgery to properly position the retina at the back of the eye. Depending on the type of retinal detachment, there are several different surgical procedures that can be performed:

• Scleral Buckle – after draining the fluid behind the detached retina, an ophthalmologist will place a tight scleral buckle (a flexible band) around the eye. This counteracts the force pulling on the retina, allowing the retina to settle back into place. The procedure is performed in an operating room.

• Pneumatic Retinopexy – during this procedure, a gas bubble is injected into your eye to press against the detached retina and push it back into position. In order to ensure the gas bubble remains in position while healing, you will need to maintain a specific head posture as instructed. Over time the gas bubble disappears. This procedure can be performed within your ophthalmologist’s office.

• Vitrectomy – with this procedure, the vitreous gel that is pulling on the retina is removed and replaced with a gas or oil bubble. The bubble acts to force the retina into its proper position until it heals. The gas bubble will gradually disappear on it’s own, but an oil bubble will need to be removed once the retina is healed. This procedure is performed in an operating room.

Post-Surgery

Following any of these procedures, it’s normal to expect some discomfort and to continue experiencing flashes or floaters while healing. You may be prescribed medications to help manage discomfort, and you will need to wear an eye-patch for a short period.

If you have a gas or oil bubble injected to help heal your retina, it is important to keep your head in the proper position for the prescribed amount of time. Until the gas bubble has dissolved, do not fly in an airplane or travel at high altitudes. Changing altitudes can cause a dangerous rise in eye pressure, however it is okay to do so in the case of an oil bubble.

Surgical Risks

Like any surgery, there are some risks involved with treating a retinal detachment:

• Infection
• Bleeding
• Increased pressure within the eye
• Cataract

Not treating a retinal detachment can result in permanent, severe vision loss or blindness. Surgeries are typically successful, but there are times when a second procedure may be required.

Will Vision Be Improved?

It may take several months for your vision to improve after a successful surgery. Depending on the individual and severity of the detachment, it is possible that your vision may not improve or return fully. It is therefore important to see your ophthalmologist immediately if you notice any symptoms of a retinal detachment. Some detachments cannot be surgically fixed. If this is the case, vision loss will continue and blindness may occur.